m 

'/w 
































































































































































































































































































































/ 




\S 


JF 



GopyiightN?_ 

COPYRIGHT DEPOSIT. 


























Portrait of the Author 












TUBERCULOSIS 


Its Cause , Nature 


and Treatment 


BY 

BERNARR MACFADDEN 

Assisted by Staff of 
Medical and Other Experts 


Author of macfadden’s encyclopedia of physical culture, 

STRENGTHENING THE NERVES, STRENGTHENING THE EYES, HAIR CUL¬ 
TURE, CGN STIP AT I ON, TOOTH TROUBLES, MIRACLE OF MILK, DIABETES, 
HEADACHES, EATING FOR HEALTH AND STRENGTH, SKIN TROUBLES, 
DIGESTIVE TROUBLES AND OTHER WORKS ON HEALTH AND SEX. 


NEW YORK 

MACFADDEN PUBLICATIONS, Inc. 

1929 


U 0 , 





■R&3W 

xWlir 


Copyright, 1929 

By MACFADDEN PUBLICATIONS, Inc. 
Also Copyright in Canada and Great Britain 


Printed in the United States of America 


FEB -2 I9?9 

©CIA 5221 




PREFACE 

r I v UBERCULOSIS has been the Great White 
Plague for ages. It is now the black, red 
and yellow plague as well, for it affects all races. It 
has been known ever since man began to think about 
diseases, and is described in some of the first books 
ever written on health and lack of health. And 
yet in spite of the thousands of years it has existed 
only within comparatively recent times has a sen¬ 
sible and successful treatment obtained sufficient 
recognition to be used to any appreciable extent. 
And all because this disease and other diseases have 
been considered entities—enemy entities which must 
be fought—instead of friends in disguise whose 
warnings we should heed and thereby learn health 
wisdom. This imperfect conception of the true 
nature of disease has been one of the most im¬ 
portant causes of the development of a great and 
foolish fear of tuberculosis. Another cause was 
the discovery of the tubercle bacillus, which gave the 
people something of which to be afraid, since this 
bacillus was given the entire blame for causing all 
the trouble. 

Now there is no real reason for this unnecessary 
fear of the disease except ignorance; and it is part 
of the purpose of this book to dispel this ignorance 
so that tuberculosis will be seen in its true light and 


PREFACE 


the sufferer will be in a position to proceed con¬ 
fidently and hopefully with treatment and thus secure 
quicker and more satisfactory results. 

It is high time that this was done, for tuber¬ 
culosis takes an enormous toll of humanity every 
year. In the United States alone 100,000 die an¬ 
nually of this disease. And this number is only a 
small part of those afflicted. It is estimated that 
at least 500,000 are under regular treatment for 
tuberculosis and that at least a million are under 
treatment part of the time. 

The greatest mortality occurs among the more 
primitive races, such as the blacks and the Indians 
after they have adopted civilized methods of living; 
and this, too, throws further light on causes. About 
nine-tenths of all cases of tuberculosis are lung cases. 
This should have pointed out the basis of treatment 
(fresh air) long ago, but it seems that humanity 
is often peculiarly dense mentally. The greatest 
mortality occurs between the ages of 15 and 35 or 40 
years. However, cases among children are frequent 
enough, though children more often are affected in 
the glands, bones or joints, rather than in the lungs. 

Tuberculosis was formerly considered a death 
warrant. No hope was held out for the unfor¬ 
tunate victim. In fact, less than one hundred years 
ago an eminent English divine proclaimed that it 
was blasphemous to try to cure a tuberculous patient 
because God himself had made the disease incurable. 
What a confession of ignorance! We can be thank¬ 
ful that the present generation, with all its short- 


VI 


PREFACE 


comings, is at least wise enough to realize that all 
things are possible. It has been only within the 
last fifty years, however, that tuberculosis has 
come to be considered a curable disease; and, 
consequently, most people still think of it as incur¬ 
able, for it does take a long time to overcome inborn 
ideas. One reason for the present pessimistic atti¬ 
tude of the general public, however, is that the sup¬ 
posed authorities still hold out hope only for the 
lighter cases, giving the advanced cases the cold 
comfort of a promise that their lives can be at least 
prolonged if they do what is necessary. But I say 
and do proclaim in all sincerity and confidence that 
practically every case can be cured if the patient is 
sufficiently confident and persistent and uses the 
right methods of treatment. 

So here again we come to the problem as to what 
treatment shall be used. The importance of prompt 
treatment is well realized, but it must be of the 
right kind. Prompt treatment of the wrong kind 
will be worse than none at all. Not a few people 
have died of treatment rather than of the disease, 
with which they were afflicted, and this applies par¬ 
ticularly to tuberculosis. It has not been so long 
ago that such patients were shut up in closed rooms 
and carefully protected from all outside air, par¬ 
ticularly during the night, with the idea of prevent¬ 
ing any possible “exposure” to drafts, cold, and 
other such “terrible” conditions. A little further 
back patients were advised to live in a cow stable 
with the idea that the “emanations” would be bene- 
vii 


PREFACE 


ficial. Before this, bleeding and purging were the 
popular methods of treatment. One authority was 
quoted as saying that if anything would cure tuber¬ 
culosis it would be bleeding and calomel. Another 
advised all tuberculous persons to “lose six ounces 
of blood per day for a fortnight.” But most of 
them did not live that long. Even now there are 
many advertised “cures” for tuberculosis. But at 
least a part of the really effective treatment is so 
well established that there is not so much danger of 
the patient going wrong. 

The thing to do is to use common sense. There 
is plenty of publicity at present on how to prevent 
tuberculosis, and if the people will realize that the 
same things which prevent will also cure they will 
not go far astray. Newspaper columns to the 
amount of half a mile every week are devoted to the 
subject of tuberculosis; and while all that is printed 
is by no means helpful there still is much that is 
good. If the reader will disregard the germ side 
of the matter and pay attention to the right habits 
of living which are advocated he need have no fear 
of the disease, and if he already has the disease 
he will be in a fair position to judge what is the 
best treatment. 

Of course, sanitarium treatment is now always 
recommended by the orthodox doctor, but this is 
by no means necessary; and unless the right kind 
of a sanitarium is chosen—and there are very few 
of the right kind—more harm than good may re¬ 
sult. If the patient stays at home, however, he 
viii 


PREFACE 


usually is under the necessity of choosing a doctor 
who can guide him in his efforts to recover his 
health or at least keep a check on his progress. Here 
again the average person is under a disadvantage, 
because there are relatively few of the right kind 
of doctors. 

He must resort to self-education by means of 
books on the subject so that he can treat himself. 
Recovery from disease is always a matter of re¬ 
education of the patient anyhow, so books of the 
right kind are very necessary. The patient is sick 
because he has not lived rightly, and he must learn 
how to live before he can get well. His symptoms 
indicate that the body is making every effort to re¬ 
store a normal condition; but unless the environment 
is changed it may not succeed. So education always 
goes hand in hand with treatment. Of course, there 
is always the objection that there is much disagree¬ 
ment in books and that what one recommends may 
be condemned by another. However, most of the 
books which advocate the wrong treatment are of 
little value anyhow, for they give little real informa¬ 
tion, contenting themselves with warnings to ob¬ 
serve strict antisepsis to kill the germs and then to 
“follow the doctor’s orders.” Most of the books 
which advocate natural methods of treatment are 
fairly well agreed on the subject so that if the pa¬ 
tient has any common sense he will get the funda¬ 
mentals and be able to separate the wheat from the 
chaff. 

However, the number of really instructive and 
ix 


PREFACE 


helpful books on tuberculosis is small; and it is 
with the sincere desire of being as helpful as possible 
that I offer this latest book on this tremendously 
important subject. I am recommending only those 
measures of prevention and treatment which have 
been proved of value through reason and experience. 
They will be found all-sufficient. It is always well 
to remember that it is the patient which must be 
treated and not the disease. When there is a choice 
of several measures the patient may respond to one 
when he will not to another. The healing forces 
of the body must be aroused as well as given a 
chance to operate; and the thing that will arouse 
these forces may vary in different cases. However, 
the fundamentals always apply. I have tried to 
make everything as plain as possible so that the 
patient will be able to select and apply his treatment 
without difficulty. 

I bring hope to all, even to the most advanced 
cases, for practically no case is incurable as long as 
life lasts. 



x 


TABLE OF CONTENTS 

CHAPTER PAGE 

Preface . v 

I. The Body in Health and Disease . . i 

II. Nature of Tuberculosis.21 

III. Susceptibility to Tuberculosis ... 30 

IV. Causes of Tuberculosis.35 

V. Symptoms of Tuberculosis.54 

VI. Treatment of Acute Tuberculosis . . 72 

VII. Treatment of Chronic Pulmonary Tu¬ 
berculosis .88 

VIII. Treatment of Laryngeal and Intestinal 

Tuberculosis.157 

IX. Treatment of Bone Tuberculosis . . 180 

X. Treatment of Tuberculosis of the Skin 

and Glands.194 

XI. Treatment of Children.205 

XII. Complications and Their Treatment . 218 

XIII. After Care of Tuberculosis .... 233 

XIV. Prevention of Tuberculosis .... 239 

XV. Equipment for Treating Tuberculosis . 246 

XVI. Medical Treatment of Tuberculosis . 269 


xi 








LIST OF ILLUSTRATIONS 


SUBJECT 

Portrait of Author. 


PAGE 

Frontispiece 

Abdomen and Pelvis, Cross Section 



5 

Skin, Magnified Cross Section . 



8 

Kidney, Cross Section. 



IO 

Bladder, Cross Section Magnified . 



12 

Lung, Globule and Air-Cells . 



13 

Larynx, Showing Vocal Cords . 



14 

Lungs, Showing Circulation to and from Heart 


17 

Tubercle Bacillus. 



26 

Fireplace Aids Room Circulation 



37 

Air Movement. 



38 

Window Ventilators. 



39 

Another Style of Window Ventilator . 



4 i 

Sleeping Porch. 



79 

Outdoor Sleeping in Cold Weather 



110 

Natural Sun Bath. 



115 

Breathing Exercise. 



127 

Breathing Exercise for Chest 



128 

Chest and Abdomen Exercise 



129 

Breathing and Body Exercise 



130 

Friction-Resistance-Breathing Exercise 



131 

Arm and Shoulder Exercise 



132 

Bending and Breathing Exercise 



i 33 

Leg and Abdomen Exercise 



134 

Neck Exercise. 



135 

Upper Body Exercise. 



136 

Another Upper Body Exercise . 



137 

Leg and Hip Exercise. 

xiii 



138 









xiv LIST OF ILLUSTRATIONS 

SUBJECT PAGE 

Arm Resisting Exercise.139 

Another Arm Resisting Exercise ..140 

Lying-Down Breathing Exercise.141 

Another Lying-Down Breathing Exercise . . . . 142 

Lying-Down Leg Exercise.143 

Lying-Down Upper Body Exercise.144 

Lying Face-Down Leg Exercise ..145 

Lying Face-Down Upper Body Exercise .... 146 

Ultra-violet Ray Lamp ........ 163 

Sunlight Radiations of the Larynx.165 

Tuberculous Children Taking Fresh Air and Natural 

Sun Baths.185 

Ultra-violet Ray Lamp Giving General Radiation . 197 

Sun Baths in Winter.. 206 

Outdoor Exercises for Children.212 

Outdoor School for Children.215 

Sleeping Porches in the Mountains.247 

Home-Made Sleeping Porch.252 

Another Home-Made Sleeping Porch.253 

Indoor Tent.. 254 

Outdoor Tent.255 

Good Tent for Outdoor Living.257 

Natural Sun Bath Taken Indoors.259 

Sleeping Bag.261 

Reclining Chair.262 

“Eskimo” Suit for Outdoor Living and Sleeping . . 263 

Sputum Cup.265 














Tuberculosis 

CHAPTER I 

The Body in Health and Disease 

T 7 VER 10 NE should know something about his 
body and how it works. If this knowledge 
were more widespread there would be much less 
disease. It is especially important for the well per¬ 
son to understand his needs in order that he may 
remain well. But it is also very important for the 
sick person to have this information in order that 
he may find the road back to health. In finding 
the road, if he is wise, he will also have found the 
way to retain health when it has been secured. The 
sick person is under the additional necessity of know¬ 
ing something about the needs of the body when 
it has broken down from abuse. Hence he requires 
an even wider knowledge than the fortunate individ¬ 
ual in good health. There is no escaping this neces¬ 
sity for study. We cannot hire another to repair 
our bodies as we can to repair our houses and ma¬ 
chines; we must do the work ourselves. The only 
assistance we can hire is a teacher who will instruct 
us in our work. The sooner people realize that 
man’s greatest study is man the sooner will disease 
be eradicated. 

The body is composed of cells and each cell is a 


TUBERCULOSIS 


little “life” in itself. Some cells may function im¬ 
perfectly without creating any noticeable effect upon 
the general health, but the effect is there just the 
same; and if any considerable number of cells is 
affected the individual will not long be left in doubt 
as to something being wrong. 

Each cell is interested in the same functions in 
which the body as a whole is interested—that is, 
nutrition, elimination, and reproduction. The food 
we absorb ultimately becomes cells or is utilized 
by cells, and the waste products of the individual 
cells must ultimately be eliminated through some 
groups of cells known as organs, such as the kidneys, 
bowels, etc. Unless each cell reproduces as it should 
there will be degeneration and ultimate death, for 
the body is constantly changing and new cells must 
be constantly produced. The old and the new cells 
must be normal cells if health is to result. This 
continual tearing down and building up is known 
as metabolism. 

It will readily be seen how important is food to 
metabolism and, hence, to the maintenance of health 
and the elimination of diseased conditions. But the 
importance of removing the waste products must 
not be lost sight of. Even with a perfect diet, if 
the elimination is not normally active a toxic condi¬ 
tion would result. This is the underlying cause of 
all disease. Looking at the body as a whole, there¬ 
fore, the digestive and eliminative organs are the 
important ones to consider in overcoming disease. 

The mouth is the first part of the digestive tract, 
2 


THE BODY IN HEALTH AND DISEASE 

and as everybody is familiar with its appearance it 
will not be necessary to describe it. But two very 
important phases of digestion are accomplished in 
the mouth. These are mastication, which reduces 
the food to a pulp so that the digestive juices can 
reach all the elements, and the mixture of the food 
with saliva which serves the double purpose of mois¬ 
tening it and of changing much of the starch to 
sugar and the complex sugars to simpler forms. The 
latter function is produced by an enzyme in the sa¬ 
liva known as ptyalin. If this has little opportunity 
to act, owing to rapid eating and insufficient masti¬ 
cation, it will mean more work for the intestines and, 
hence, more cause for them to become weakened and 
susceptible to tuberculosis, and tuberculosis in the 
intestines is no picnic. The tube connecting the 
mouth with the stomach is known as the esophagus. 
It serves simply as a passageway for food and is 
seldom affected with tuberculosis. 

The next organ is the stomach. This is a pouch¬ 
like receptacle for the food, located approximately 
in the center of the body just below the breast bone. 
The stomach is lined with mucous membrane, in 
which are the glands which secrete the gastric juice 
which contains two enzymes, pepsin and rennin, and 
the highly important hydrochloric acid which makes 
pepsin an efficient enzyme. The walls of the stom¬ 
ach are composed of muscles whose function it is to 
contract the organ with rhythmic motions so that 
the food is well mixed with the gastric juice. The 
function of the pepsin is to digest protein foods. 

3 


TUBERCULOSIS 


Contrary to the popular idea, there is not much 
digestion taking place in the stomach, the protein 
being the only element which is affected to any ex¬ 
tent. The stomach is really more for storing the 
food, mixing it thoroughly, and getting it ready for 
the main work of digestion which takes place in the 
intestines. As the mouth prepares for the stomach, 
so the stomach prepares for the intestines. Never¬ 
theless, the work of each is important, and if neg¬ 
lected or imperfectly performed it means trouble 
later on in the digestive tract—and in life, as well. 
The rennin, which is the other enzyme in the gastric 
juice, curdles milk. This is its sole function, but 
the curdling must be done before the milk can be 
digested. The persistence of the rennin throughout 
life is one proof that milk is a natural food for the 
adult and not a poison, as some misguided theorists 
claim. After the food has been thoroughly mixed 
by the stomach, partly digested and rendered acid in 
reaction by the gastric juice, it is ready to be passed 
on into the intestines. At this stage it is called 
chyme (from a Greek work for juice). 

The normal chemical condition of the mouth fluid 
is alkaline, and the food should be alkaline when it 
reaches the stomach, as this stimulates the flow of 
the acid gastric juice. The normal state of the 
stomach secretions being acid, as soon as an alkali 
is injected there is a tendency for the stomach to 
secrete more acid in order to maintain the normal 
acidity. The acidity of the stomach contents, on 
passing into the intestines, stimulates the flow of 
4 


THE BODY IN HEALTH AND DISEASE 


the intestinal digestive juices, since these latter are 
alkaline and the normal chemical condition of the 
intestines is alkaline. It will be seen from this that 
the use of chemical alkalies to overcome hyperacid¬ 
ity of the stomach only results in making the condi¬ 
tion worse as the alkali stimulates the production 

of more acid. 
If the food 
is properly 
prepared in 
the mouth 
there will be 
little tend¬ 
ency toward 

ach even if 
the diet is 
not all that 
it might be. 

The intes¬ 
tines are the 
most compli¬ 
cated part 
of the di¬ 
gestive tract and as they are often affected with 
tuberculosis we will consider them in somewhat 
more detail. The intestine is a muscular tube about 
thirty feet in length, twenty-five feet of that length 
being the small intestine, so-called because it is only 
about an inch in diameter. The remaining five feet 


hyperacidity 
of the stom- 



BLADDER' 


CESSER. SAC 


PANCREAS 

DUODENUM 

TRANSVERSE 

COLON 

MESENTERY 


A cross-section of the female abdomen and 
pelvis. Any of the organs shown may be 
affected with tuberculosis but the intestine 
is most frequently attacked. 





TUBERCULOSIS 


make up the large intestine, which is not a digestive 
organ but an eliminative organ, and a very impor¬ 
tant one at that. The intestines are built like the 
stomach in that they have muscular walls and are 
lined with mucous membrane which (in the small 
intestines) contains glands. The muscles in the 
walls of the small intestines are chiefly arranged cir¬ 
cularly and contract with a wave-like motion so that 
the food is gradually forced along the tract. In 
the large intestine there are more developed longi¬ 
tudinal muscles, which by contracting help to hold 
back the food so that it will not move along so 
rapidly and will have time to dry out to some ex¬ 
tent, thereby producing a semisolid material for 
evacuation. All these muscles must be in good work¬ 
ing order if we are to avoid constipation with its 
long train of ills. Constipation is a strong predis¬ 
posing factor to tuberculosis, as it is to all other 
diseases. 

As most of the digestion has to take place in the 
intestines three digestive juices are found there, the 
bile, pancreatic juice, and the intestinal juice. The 
bile has other functions also, the most important 
of which are to keep the food from decomposing 
in the warm, moist intestine, and to stimulate the 
wave-like motions of the intestine, known as peri¬ 
stalsis. The pancreatic juice is secreted by the pan¬ 
creas. This secretion has to do the most work of 
all. It contains three enzymes, trypsin, amylopsin, 
and steapsin, which digest proteins, starches, and 
fats respectively. The digestion of the starches 


THE BODY IN HEALTH AND DISEASE 


starts in the mouth and is finished in the intestines. 
The digestion of the proteins starts in the stom¬ 
ach and is finished by the pancreatic juice, assisted 
by the intestinal juice (succus entericus). The lat¬ 
ter juice is secreted by glands in the walls of the 
intestines, and has its action mostly on the less com¬ 
plex protein material. 

It will be noted that nothing has been said about 
the digestion of the mineral salts and vitamins which 
are receiving so much attention at present and which 
are without doubt even more important than the 
proteins, fats, and carbohydrates (starches and 
sugars). This is because as far as we know now 
they require no digestion but are directly absorbed 
the same as water—an extremely wise provision of 
Nature. These are absorbed partly from the stom¬ 
ach but mostly from the intestines. The other 
food elements are all absorbed from the intestines. 

After the food elements have been removed by 
absorption, the residue is passed on into the large 
intestine where some more of the water is absorbed 
and the remaining solid material ejected during 
defecation. If this refuse is not promptly and regu¬ 
larly removed it soon undergoes fermentation and 
putrefaction, with the production of injurious 
gases and other toxins which will be absorbed into 
the blood stream and cause trouble of some kind, 
greater or less according to several factors. 

Let us now proceed to a consideration of the elim¬ 
inative organs. We have seen how food gets into 
the body, what happens to it and how the residue 

7 


TUBERCULOSIS 


is eliminated by one of the depurating organs—the 
bowels. But we also take water and air into the 
body and some of this must be eliminated. Then, 
too, there are other forms of waste material pro¬ 
duced by muscular and organic action which must 
be disposed of, not to mention the many foreign 

articles we are contin¬ 
ually putting into the 
body, such as dust, 
dirt, bacteria, drugs 
and medicines of all 
kinds, tea, coffee, 
spices, tobacco, alco¬ 
hol, synthetic soft 
drinks, etc. All these 
must be thrown out of 
the body by the skin, 
kidneys, bowels, and 
lungs. All too often 
they have a tremen¬ 
dous amount of work 
to do, and while they 
can stand much abuse 
they will break down 
sooner or later if not given a rest. When they do 
break down they may become tuberculous. 

The skin has other functions to perform besides 
that of elimination. It is the protecting surface of 
the body, being composed of several layers of cells, 
the outer ones quite tough and resistant, yet elastic. 
The outer layer of the skin, whose chief function 



A greatly magnified cross-section 
of the skin, showing its marvel¬ 
ous and complicated structure. 









THE BODY IN HEALTH AND DISEASE 

is protective, is called the epidermis. The next 
layer, which contains the tiny muscles which move 
the skin, the blood vessels which feed it and the 
nerve endings of the sense of touch, as well as the 
oil glands, is called the derma or true skin. Under¬ 
neath this is the subcutaneous layer, which is com¬ 
posed of connective tissue for joining the skin to the 
underlying tissues. It also contains fat cells and 
the sweat glands. The ducts of the sweat glands 
pass up through the derma and open onto the free 
surface of the epidermis. The sebaceous or oil 
glands also open onto the surface of the epidermis. 
These latter secrete an oil which serves to keep the 
skin soft and pliable and also acts as an additional 
protective agent the same as oil minimizes wear in 
an engine by taking up friction. The primary func¬ 
tion of the sweat glands is to regulate the tempera¬ 
ture of the body by producing perspiration when the 
body or external temperature becomes too hot. The 
evaporation of this perspiration causes cooling of 
the body. Certain waste products are eliminated 
in the sweat, also, and when the body is very toxic, 
considerable amounts of these impurities may thus 
be thrown off. This is why a sweat bath or the 
sweat resulting from exercise helps to cleanse the 
body. In addition to these duties the skin also 
breathes to a certain extent, thus assisting the lungs 
in their function, which will be explained later. 

The skin may be affected with tuberculosis, but 
only if it is under the necessity of eliminating a 
lot of toxins so that there is plenty of food material 


TUBERCULOSIS 


for the germs. Of course, if the skin is not kept 
clean it will be more susceptible to tuberculosis. 

Closely associated with the skin in the work 
of elimination are the kidneys. These are two 
bean-shaped organs located slightly above the so- 
called “small of the back.” The right kidney is 

somewhat lower 
than the left, 
but the lower 
edge of each 
teiffcV is approximately 
two inches 
above the upper 
edges of the hip 
bones. The kid¬ 


neys are con¬ 
nected by tubes 
called ureters 
with the blad¬ 
der, located in 
the lower front 
of the pelvis. 
The bladder is 
connected with the outside of the body by another 
tube called the urethra. The kidneys themselves are 
composed of many tiny tubes or tubules surrounded 
by blood-vessels. All these tubes converge to empty 
into the ureters. 

As probably everyone knows, the function of the 
kidneys is to secrete urine. Urine is composed 
largely of water, but there are also considerable 
10 



PYRAMID 

A cross-section of the kidney show¬ 
ing its various parts. This organ 
may be affected with tuberculosis, 
producing serious complications. 



THE BODY IN HEALTH AND DISEASE 

amounts of solid waste materials, most of which 
come from the end-products of protein digestion or 
from the destruction of tissue cells occasioned by 
the activities of the body. These waste materials 
are brought by the blood to the kidneys, and here 
they are collected in the little tubules of the kidneys 
through a process somewhat resembling filtration. 
This collection, in dilution, flows into the bladder 
through the ureters as rapidly as formed. It is then 
stored in the bladder until this is fairly full, when 
there will be a call to urinate and pass it out of the 
body. The normal amount of urine is about three 
pints per day, but this varies considerably with 
the quantity of liquids taken in the diet and the 
amount of perspiration. 

The functions of the skin and kidneys are closely 
related, as the process of secreting sweat does not 
vary greatly in its fundamentals from that of the 
secretion of urine. When we perspire freely there 
will be less urine, but when we perspire very little 
there will be more urine. This is a normal relation¬ 
ship between kidneys and skin and their excretions. 
It is even more pronounced in abnormal conditions. 
In other words, if the skin is not normally active 
the kidneys will have more work to do, and vice 
versa. In fact, all the eliminative organs are thus 
connected. If one fails to any extent more work is 
thrown on the rest. 

Through overwork occasioned by improper diet 
and the resulting necessity for eliminating an excess 
of solid materials, the kidneys may become irritated 

11 


TUBERCULOSIS 


or actually inflamed. When in this condition they 
furnish soil for the tubercle bacillus and many an 
unlucky patient has had his kidney removed because 
it was tuberculous. Not that there is any necessity 
for doing this, but such usually is the medical pro¬ 
cedure. It is possible to live with only one kidney, 



PROSTATE 

^EJACULATORY 
DUCT 
-PROSTATE 


LONGITUDINAL 

FIBRES 

CIRCULAR 

FIBRES 

ORIFICE OF 


TRANSVERSE 
FIBRES OF 
TRIGONE 

LONGITUDINAL 
FIBRES OF 
TRIGONE 


A magnified cross-section of the bladder, showing the openings 
for both the urethra, which goes to the kidney, and the urethra, 
which connects the bladder with the surface of the body. The 
prostate gland is also shown. 


but much care will be necessary to avoid overwork 
and destruction of the one organ. We should keep 
both our kidneys as long as possible, and if given 
proper care they will last indefinitely. 

We now come to a consideration of the lungs, 
12 







THE BODY IN HEALTH AND DISEASE 


those unfortunate organs which are so often afflicted 
with tuberculosis. We will not consider the reason 
for this here but will discuss it later. For the pres¬ 
ent let us look at their structure and function, a 
knowledge of which will be necessary for a proper 
understanding of the various matters to be taken up 
later in this book. Every one should know about the 
lungs anyway, for they are vitally important, this 
being demonstrated by the fact that there are few 
things which will bring about death sooner than fail¬ 
ure of the lungs to act. If you doubt it, try having 



A magnified view of a globule of the lung and of a group of 
air-cells (alveoli) and their connecting ducts and bronchioles. 
A lobule is made up of a great number of alveoli. 


someone choke you or see how long you can hold 
your head under water. The average person will 
become unconscious in about two minutes if his air 
supply is cut off. 


13 


TUBERCULOSIS 


The air enters the lungs through the nose, mouth, • 
larynx and trachea, or windpipe. In a single day 
the lungs handle on an average of 105 barrels of 
air. All are familiar with the mouth and nose, but 
most people know little about the larynx. This is 
really the voice-box, as it is here that the vocal 
cords are located and it is through the contraction 

TRUE 



A view of the larynx, looking down upon its top so that the 
vocal cords are seen. Any of the parts shown may be affected 
with tuberculosis, producing a very painful and serious 
condition. 

and relaxation of these cords that sounds are pro¬ 
duced. The larynx is a box-like structure composed 
chiefly of cartilage, though it has both extrinsic and 
intrinsic muscles attached for moving it and the 
vocal cords. The front cartilage is the chief one 

14 



THE BODY IN HEALTH AND DISEASE 


and is called the thyroid cartilage. It is the familiar 
“Adam’s apple.” Below and behind this is the 
cricoid cartilage. Above the back of the cricoid and 
forming the back of the larynx are the two arytenoid 
cartilages. The top of the larynx is closed with 
another cartilage called the epiglottis. This is 
hinged and moves up and down so as to open the 
larynx when breathing and close it when swallowing 
food, as the food has to pass over the larynx on its 
way to the stomach. When the larynx is affected 
with tuberculosis it often becomes ulcerated and 
swollen, especially about the epiglottis and arytenoid 
cartilages; and this interferes greatly with swallow¬ 
ing and breathing, often leading to serious results. 
The vocal cords also may be affected, producing 
hoarseness or loss of voice. These cords are in two 
sets. The upper set is known as the false cords and 
the lower as the true cords. They are small liga¬ 
mentous bands passing from the front to the back 
of the larynx with an opening between. By con¬ 
tracting or relaxing the cords this opening may be 
enlarged or closed. When closed, either naturally 
or because of swelling, no air can pass. 

The trachea or windpipe is a tube composed of 
cartilage, muscle, and mucous membrane which leads 
from the larynx down through the chest to where 
it divides into two branches called the bronchi. One 
bronchus goes to the right lung, the other to the left 
lung. Each bronchus divides and subdivides, much 
like the branches of a tree (only inverted), so that 
a very large number of small tubes are formed, 
15 


TUBERCULOSIS 


called bronchioles. On the end of each bronchiole 
there is a membranous sac, the air-cell. It is these 
bronchial tubes and air-cells, together with blood 
vessels, nerves, and connective tissue, which make 
up the substance of the lungs. 

The lungs are pyramidal in shape, being held in 
this form by the chest cavity and by a fibrous cov¬ 
ering called the pleura. The chest cavity is lined 
with a similar membrane and the very small space 
between these two layers of pleura is filled with 
lubricating fluid so that the movements of the lungs 
will not cause friction. Each lung is partly divided 
into sections called lobes, the right lung having three 
lobes, the left lung only two lobes in order to make 
room for the heart, which lies between the lungs. 

During breathing the lungs expand as the air en¬ 
ters, and contract, because of their elasticity, as the 
air leaves. Inspiration is a muscular effort which 
raises the ribs and lowers the diaphragm (the muscle 
forming the base of the. chest cavity) so that the 
size of the chest cavity is increased and the air 
rushes in because of the difference in the inside and 
outside air pressures. Expiration, during quiet 
breathing, is simply a relaxing of the muscles so 
that the ribs are allowed to descend and the dia¬ 
phragm to ascend, thus decreasing the size of the 
chest cavity and forcing the air out. It is because 
of these different movements that pain and various 
other symptoms are produced when the lungs or 
pleura become affected with tuberculosis, and when 
adhesions form as a result of this trouble. 


16 


THE BODY IN HEALTH AND DISEASE 


The purpose of breathing is to bring the fresh air 
containing a good supply of oxygen into approxima¬ 
tion with the blood so that it can absorb oxygen 
and throw off carbon dioxide, which is then 
breathed out during exhalation. This interchange 



RIGHT pulmonary 

ARTERY Z, VEIN 


HEART 

'INFERIOR. LOBE 

A view of the lungs showing the circulation to and from the 
heart. All the blood must pass from the heart to the lungs to 
be purified before it is returned to the heart to be distributed to 

the rest of the body 

of gases takes place in the air-cells above men¬ 
tioned. These cells are surrounded by many fine 
blood-vessels, and the membranes forming the walls 
in each case are so thin that the gases can pass 
through, but solids and liquids are held back. Thus 
the blood is prevented from escaping into the lungs, 
and the air as a whole is prevented from entering 
the blood-vessels, also any foreign material which 
may be contained in the air. Such foreign matter 
may remain in the air cells or bronchial tubes, how¬ 
ever, and cause much trouble. 


17 



TUBERCULOSIS 


A plentiful supply of oxygen is extremely neces¬ 
sary at all times, for it is used to support metabo¬ 
lism, which I shall explain presently. Oxygen also 
enters into all the tissues so that the body would 
almost evaporate without it. The body is three- 
fourths water and water is one-third oxygen. An 
ample supply of oxygen at all times, not only in 
the lungs but in the tissues, is one of the best pre¬ 
ventives of tuberculosis. 

Now what is metabolism? It is the breaking 
down and building up of tissue. As the body is 
used, certain of the older cells in all parts wear out, 
die, and must be replaced. The cells use oxygen 
in their functions and when they die they must either 
be consumed (burned) by oxygen or eliminated 
from the body in some other manner. If they are 
allowed to remain they interfere with normal func¬ 
tions. In building up new cells, oxygen is necessary 
for combining with food materials to form the cells 
and to furnish food material for the cells. Thus 
you see further the importance of oxygen and why 
tuberculosis, through interfering with the function 
of the lungs, brings about such serious general symp¬ 
toms as it does. 

This breaking down and building up of tissues 
must be balanced if we are to have health. If more 
cells die than are replaced we will naturally deterio¬ 
rate. If more cells are produced than are used 
up we will grow in some way. During childhood 
it is very important that more cells be built in order 
to produce growth. Metabolism is therefore more 
18 


THE BODY IN HEALTH AND DISEASE 


rapid in the child than in the adult. The child be¬ 
comes sick more quickly if the environment is bad, 
but it also gets well more quickly under the proper 
treatment. When a person has not been living 
rightly this normal interchange of tissue may be 
perverted in many ways and this is responsible for 
the many varying symptoms which we call disease, 
but which in reality are merely different manifesta¬ 
tions from the same causes. 

If toxins of any kind are allowed to accumulate in 
the body, whether their source be from the outside 
or from the inside, the effect is to place obstacles* 
in the way of this building up of tissue and to pro¬ 
duce a greater breaking down of tissue. The body 
could not long exist under these circumstances, and 
must do something about it. What we call disease, 
therefore, is only Nature’s effort at removing 
these obstacles or toxins. The eliminative func¬ 
tions of the body are greatly accelerated and this 
gives rise to many symptoms such as fever or the dis¬ 
charge of mucus, etc., which are called abnormal. 
As a matter of fact, however, they are normal under 
the circumstances. They are abnormal only because 
the conditions are abnormal. 

What we ordinarily call disease—and this in¬ 
cludes tuberculosis—is therefore only a physiolog¬ 
ical process which is produced by the guiding intel¬ 
ligence within the body for the best interests of 
the body in order to clean out the excess of toxins 
and to warn us to discontinue the wrong habits of 
living which are producing the toxins. Therefore 
19 


TUBERCULOSIS 


we should look upon so-called disease as a friend. 
By so doing we will lose our fear of disease and 
thus be in a better position to profit by a correction 
of the habits of living. For even perfect habits will 
not produce perfect health if fear is allowed to in¬ 
hibit and alter all the functions of the body. Of 
course, fear is itself a bad habit. 

From the description here given you should be 
able to visualize fairly well the normal functioning 
of the organs most often affected by tuberculosis. 
If you will visualize all the organs functioning nor¬ 
mally as here described, and especially any which 
may be diseased, it will help much to accelerate your 
progress toward health. More of this hereinafter. 
For the present, try to remember what I have told 
you of the different parts of the body and how they 
work, for it will help you much in understanding and 
utilizing the suggestions that will be given in the 
subsequent pages. 


20 


CHAPTER II 

Nature of Tuberculosis 


TfVER since the bacillus tuberculosis was discov¬ 
ered by Koch in 1882 the medical doctors have 
claimed that this was the cause of the disease and 
that the nature of the symptoms was determined 
entirely by the type of germ and its activities. They 
maintain that the prevalence and destructiveness of 
the disease are due to the numbers and virulence 
of the germs. They have long laid great stress 
upon hunting out and exterminating the bacillus. 
People were so impressed with the fear of the 
“bugs,” as they were familiarly called, that they 
were afraid to go within a mile of any one having 
tuberculosis. Often the patient’s own family would 
desert him. 

The truth of the matter is that tuberculosis is 
essentially a filth disease—that is, internal filth. The 
germs are necessary as scavengers; and if tuberculo¬ 
sis did not develop, something else would develop, 
because the body could not continue to exist when 
overloaded with toxins. Of course, external filth 
is also a factor, because it does to some extent inter¬ 
fere with internal cleanliness. 

The disease is most prevalent among the poorer 
classes, especially in the cities, where the living con¬ 
ditions are the worst and the struggle for existence 
the most severe. Denatured, partly decomposed, 
21 


TUBERCULOSIS 


and artificially preserved foods are used because of 
their cheapness; but they produce many toxins in 
the body, and lower vitality through failing to fully 
nourish. Ventilation is very poor and sometimes 
wholly absent in the dwellings of these poor people, 
and elimination is checked. 

However, rich people also are affected by tuber¬ 
culosis. They may suffer just as much from malnu¬ 
trition as the poor, because they are inclined to buy 
the fancy foods which appeal to the taste and sight 
but which have had the life principle removed by 
manufacturing processes. On the other hand, they 
may be overfed, and this, too, leads to toxemia. 
Many times they suffer nearly as much from lack 
of fresh air as do the poor, not because they cannot 
get it but because they are too lazy to go out and 
get it, or coddle themselves in overheated rooms or 
shut their windows and draw the curtains to pro¬ 
tect their valuable furnishings from the dust and 
sunlight. The rich are almost always enervated 
from overindulgence in all the pleasures of sense. 
Thus they may become as lacking in vitality as may 
the poor. Nevertheless, though many cases occur 
among the rich, they are not so frequently affected 
as are the poor. They do have better opportuni¬ 
ties for keeping themselves in good condition, and 
in the main they take advantage of them. 

It will be seen from these facts that the real 
nature of tuberculosis is that of an eliminative crisis 
which is brought about by the body in its efforts to 
remove the accumulated toxins generated as a result 
22 


NATURE OF TUBERCULOSIS 


of wrong habits of living—plus starvation resulting 
from a deficient diet and deficient sunlight and fresh 
air. 

This is true of both the acute and chronic forms. 
The chronic form perhaps can not be called a crisis; 
but it is an eliminative effort—retarded because of 
deficiency of necessary elements and of vitality. 
The acute form is generally a result of a rapid ac¬ 
cumulation of toxins so that the germs find very 
favorable conditions for simultaneous development 
in all parts of the body. There is also a rapid les¬ 
sening of the vitality, usually from dissipation but 
sometimes from other diseases, which prevents the 
body from eliminating as it sfiould and from re¬ 
sisting the germ development as it ordinarily would. 
The chronic form of the disease usually follows a 
long period of only moderately wrong habits of liv¬ 
ing, and the accumulation of toxins is gradual. There 
has not been such a rapid lowering of vitality, hence 
the body has been continually resisting destructive 
influences, and many of the toxins and germs which 
have developed from time to time have been killed 
or eliminated before general symptoms developed. 
Finally, however, resistance is broken down and 
so many toxins accumulate that a more powerful 
eliminative effort is required. Definite general 
symptoms then appear. 

It matters not which part of the body is affected, 
the nature of the disease is the same and the funda¬ 
mental causes are the same. Thus all forms of 
the disease are related other than by the germ. 

23 


TUBERCULOSIS 


The disease may appear in more than one part of 
the body at the same time or at different times. 
The particular part of the body affected depends 
on which part happens to be weakest at the time. 
There are many factors which govern this. These 
will be taken up more fully when considering 
susceptibility in the next chapter. From the medi¬ 
cal standpoint the part affected dpends on whether 
the germ is inhaled, swallowed, or enters the body 
in some other way. But many people imbibe con¬ 
siderable numbers of the germs in various ways yet 
never have the disease. Other people may have 
it who apparently have never come in contact with 
the bacillus, at least from an active case of tubercu¬ 
losis. There is considerable reason for believing 
that the germ may develop from some other form 
when the environment is favorable for such change. 
The germ, because of its nature and the toxins given 
off during its life processes, may determine the 
symptoms to a considerable extent; but the food 
material on which it feeds—that is, the toxins— 
also determines to a considerable extent what form 
the germ will take. So no matter how you look 
at it, it is the accumulated filth in the body which de¬ 
termines the nature of tuberculosis. 

This disease is technically called phthisis and pop¬ 
ularly called consumption, especially when the lungs 
are affected. However, the most commonly em¬ 
ployed term is tuberculosis. Tuberculosis means a 
disease of tubercles or the process of the formation 
of tubercles. The tubercle is the characteristic 


24 


NATURE OF TUBERCULOSIS 


lesion. Its nature is supposed to be due to the 
nature of the germ. Perhaps it is partly; but its 
characteristics are really a result of the particular 
reaction or the particular form of offensive pre¬ 
sented by the body in fighting the germ and the 
toxins. The bacillus, of course, does have certain 
characteristics of its own which differentiate it from 
other bacteria. 

The bacillus tuberculosis is a short, rod-shaped 
non-motile bacterium from 3 to 4 microns in length 
and beaded in appearance. It belongs to the veg¬ 
etable kingdom, and reproduces itself by division. 
It does not grow and multiply to any appreciable 
extent outside the body, for it does not find the 
necessary nourishment; but it will remain alive and 
ready to develop for considerable periods of time 
if the environment is favorable, especially in dark, 
damp, dirty places. It requires dampness and dark¬ 
ness in its habitat. It may be killed in one hour 
by direct sunlight and in eight to twelve hours by 
diffuse sunlight. It is one of the easiest killed of 
all germs when not protected by the capsule, which 
forms around it, as described below. 

The typical lesion produced by the body in its 
efforts to destroy the toxins and the germs is called 
the tubercle. This is a small, grayish, translucent 
nodule, firmly imbedded in the tissues, and is formed 
of the bacilli, and giant cells surrounded by a layer 
of spindle-shaped connective tissue cells called 
epithelioid cells. These are produced by the body 
in an effort to wall off the germ and thus prevent 
25 


TUBERCULOSIS 


it from multiplying and extending its activities. 
Outside the epithelioid cells is a layer of lymphoid 
cells, which are leucocytes or white blood cells. 
These are the policemen of the blood, whose busi¬ 
ness it is to kill or absorb germs and other toxins 
which may gain entrance to the body or which may 
be developed within the body. They are outside 
the epithelioid cells to be ready for any germs which 
may escape this surrounding or incapsulating wall. 
The germs are found chiefly in the giant cells at 
the center of the tubercle, and 
in and between the epithelioid 
cells; but in the later stages 
they are also found in the 
lymphoid cells. No blood 
vessels are formed in the tu¬ 
bercle, since it is not a natural 
part of the body. The tu¬ 
bercles vary considerably in 
size, some of them being 
microscopic and others quite 
large. The larger ones are 
the older ones which have 
been growing in spite of the 
body’s efforts. Sometimes a 
number of the smaller tubercles which may be close 
together will coalesce and form a larger one. 

When the germ first enters or is developed within 
the body it starts to grow and reproduce itself, 
if there is food (toxins) for it; however, without 
food it naturally will die. If it does start to de- 
26 



The tubercle bacillus 
as seen under the 
microscope. The 
usual rodlike form is 
sometimes curved. 
This bacterium be¬ 
longs to the vegeta¬ 
ble kingdom and 
reproduces by divi¬ 
sion. 


NATURE OF TUBERCULOSIS 

velop a tubercle is formed. The bacillus, then be¬ 
ing shut off from its food supply, will die or at 
least remain dormant. If, however, there is suf¬ 
ficient food material present for the germs to 
develop and multiply while the wall is forming the 
wall may fail to develop completely or may be 
broken down, with the result that the germs spread 
and start other tubercles. When the protecting 
wall is not properly formed the tubercle undergoes 
degeneration, a process called caseation, because a 
cheesy substance is formed. This process is some¬ 
what akin to the formation of pus following an 
ordinary infection. If a number of tubercles co¬ 
alesce and then undergo caseation a cavity may be 
formed. If this is near a blood-vessel the vessel 
walls may be involved so that a hemorrhage is 
produced. When the tubercle is near the surface of 
the body an ulcer may be formed. At any time, 
however, that the body develops enough resistance 
to build the protecting wall about the spot of in¬ 
flammation, progress of the “disease” will be 
checked. This increase in resistance may be brought 
about by a correction of the habits of living; and 
if, at the same time, the causative toxins are re¬ 
moved by eliminative treatment, recovery will soon 
result. 

The extent of the disease depends not on the 
number of germs with which one may come in 
contact, but on the amount of toxic material in the 
body to serve as food for the germs, and on the 
amount of individual vitality and resistance. Most 
27 


TUBERCULOSIS 


people have had active tuberculosis germs in their 
body at some time, but they have been successfully 
walled off and rendered impotent so that the per¬ 
son never knew that they were present. On the 
other hand, others have so little resistance and so 
many toxins that the disease continues to spread 
until very marked symptoms develop. If proper 
treatment is not instituted the body’s efforts to 
cleanse itself may fail; and being then in no con¬ 
dition to continue living, the community life will 
depart and the germs will reduce the individual cells 
to the original elements from which they came, to 
be used again in building other forms of life. 

Always remember, however, that the body is 
continually fighting to maintain its existence and if 
given half a chance it will do so. Healing of tu¬ 
berculosis is difficult only because proper measures 
usually are not adopted until the disease is con¬ 
siderably advanced and the vitality greatly reduced. 
Incipient cases are readily cured, even by only par¬ 
tially correct treatment. However, even these 
cases may be difficult because people are very un¬ 
ready to give up their wrong habits of living until 
or unless death is just around the corner; and some¬ 
times the afflicted person’s environment is very un¬ 
favorable and yet very difficult to change. Recovery 
depends entirely upon cleansing the body of the 
accumulated toxins which form the soil and food 
for the germs, and upon increasing the vitality so 
that the fighting forces of the body may throw 
up a strong protecting wall about the germs or about 
28 


NATURE OF TUBERCULOSIS 


any cavities which may have been formed. In the 
case of a cavity in the lung, if one takes the proper 
care of himself, the space is gradually filled in with 
firm connective tissue forming a scar. Normal 
lung tissue will not grow again and the capacity 
of the lungs will be somewhat reduced on that ac¬ 
count. But as one can live in reasonable health 
with only one lung or even less than one lung, there 
seldom is sufficient destruction of tissue but what 
good health can be restored. 

So do not think of tuberculosis as such a terribly 
desperate and fatal disease, but merely as a tem¬ 
porary condition, necessary for the time being, but 
which can be removed by removing its causes. 


29 


CHAPTER III 

Susceptibility to Tuberculosis 

G USCEPTIBILITY, or that particular state 
^ which renders a person liable to the develop¬ 
ment of a certain disease, is usually blamed chiefly on 
heredity; but the habits of living are much more re¬ 
sponsible. Authorities are fairly well agreed that 
tuberculosis is not directly inherited; that is, a child 
born of a tuberculous mother seldom if ever has the 
disease at birth. Tuberculosis in the father does not 
seem to make any difference in this respect, either. 
Yet tuberculous parents should not have children, not 
only because of their own welfare, but because the 
children will not be as strong and healthy as they 
should be; and while it may not immediately show 
signs of the disease it will be more likely to de¬ 
velop it if the habits of living are not right. In 
other words, while a child does not inherit the 
disease it may inherit the susceptibility to it. 

An inherited susceptibility consists of weakness 
of certain organs and what might be called organic 
habits, as well as mental habits. We all are prod¬ 
ucts of the reactions of our ancestors to their en¬ 
vironments as well as of our own reactions to our 
past and present environments. There may have 
been factors in the lives of our ancestors which 
placed a particular strain on certain organs so that 
they were weakened or diseased. Nature always 
30 


SUSCEPTIBILITY TO TUBERCULOSIS 


attempts to take care of the child, and most chil¬ 
dren are born healthy. But when these weakening 
influences have continued for a number of genera¬ 
tions the children will begin to manifest an enfeeble- 
ment of the same organs that were weak in their 
parents. The lungs, the glands, the intestines, etc., 
therefore may be lacking in normal resistance and 
be susceptible to further abnormalities. 

Then, again, these same weakening influences 
have called for a certain reaction from the organ¬ 
ism, and when these reactions are repeated for gen¬ 
eration after generation organic habits of reaction 
are developed. In this way some people may be 
inclined to acute reactions and others to chronic 
reactions; some may be inclined to inflammations 
and others to degenerations; some may be inclined 
to headaches and others to skin eruptions. So, 
some people are inclined to the production of the 
symptoms known as tuberculosis when their bodies 
become overloaded with toxins, while others may 
react with pneumonia, or kidney disease, or cancer, 
etc. The lungs most often are affected with tu¬ 
berculosis, because the mucous membranes of the 
respiratory passages are generally the first to be 
called upon for extra elimination. This has been 
going on for generations, so that an organic habit 
has been developed; and most individuals during 
their lives give the body every opportunity to per¬ 
petuate this habit by continually creating cause for 
extra elimination. In this way the lungs are grad¬ 
ually weakened. Of course, the particular condi- 
31 


TUBERCULOSIS 


tions present at the time when a reaction of some 
kind becomes necessary will also determine to a 
large extent just what form the symptoms will take. 
This is where the mental habits and the germs 
enter the picture. 

Mental habits develop the same as organic hab¬ 
its; in fact, organic habits are, fundamentally, men¬ 
tal habits. However, by mental habits I refer here 
to the habits of mental expression. Some people 
when hurt or angered will react with a violent out¬ 
burst of temper, while others will react with sulks, 
or with suppression of the feelings so that there 
are no visible outward manifestations. The first 
named group is more inclined to the purely phys¬ 
ical disease, while the last two are more inclined 
to the nervous and mental disease. Another fac¬ 
tor which enters here is the dread of a certain dis¬ 
ease, which may be born in people because their 
ancestors have dreaded it for generations or it may 
be impressed during childhood. Some member of 
the family may have had a disease, such as tuber¬ 
culosis, and perhaps died of it because of improper 
treatment, and all the other members of the family 
thereby developed a dread of it and may have 
taught that dread to their children. 

An inherited susceptibility, therefore, may be an 
inherited weakness of certain organs or tissues or 
inherited habits of mental and physical reaction, 
or both. None of us can wholly escape these influ¬ 
ences, and all too often they will work out into 
manifestation in a person’s life. They do not al- 
32 


SUSCEPTIBILITY TO TUBERCULOSIS 


ways do so, however, because all persons in a family 
that may be inclined toward tuberculosis or some 
other disease do not suffer from that disease. What 
is it, then, that perpetuates and develops this sus¬ 
ceptibility to such an extent that the disease finally 
develops? Briefly, wrong habits of living. 

A person who is clean internally and externally 
need never fear tuberculosis or any other disease. It 
is those persons who insist on living wrongly, so 
that they are filthy inside, who need to watch out 
for tuberculosis. I do not say they need to fear 
it—they should not; but they should realize that 
they are making themselves susceptible to it. 

If you wish to know whether you are susceptible 
to tuberculosis do not look so much at your heredity, 
your age, your sex, or your chances of exposure to 
the germ, but at your habits of living. Do you 
live according to the laws of Nature, or according 
to your own sweet or contrary whim? Are you in¬ 
dulging in all sorts of destructive habits, or do you 
follow a regular plan of healthful living? Even 
a person who has a marked inherited susceptibil¬ 
ity to tuberculosis may avoid all manifestations of 
the disease by right living. This is proved by the 
excellent results secured in caring for pretubercular 
children—where tuberculosis seems to threaten, 
but where no lesions yet have developed. Fresh air, 
proper food, balanced exercise and rest soon build 
up their vitality to the point where they are able to 
resist any number of germs. A high vitality is 
proof against any disease. While a high or a 
33 


TUBERCULOSIS 


low vitality can be inherited, the state of vitality 
of any individual from day to day depends chiefly 
upon his habits of living. A high vitality may be 
wasted so that disease is always imminent, while 
on the other hand a low vitality may be conserved 
so that health is constant. The low vitality can 
also be increased, as is proved by the many people 
who recover from tuberculosis. 

There is every reason, therefore, to assert with 
confidence that the healthy person can avoid tuber¬ 
culosis and the person already affected can recover 
if each is willing to do what is necessary. Even 
cases which have been given up to die by more than 
one doctor have lived to see those doctors placed 
in their graves. So in reading further in this book 
I want you to put ideas of susceptibility in the 
background, and to concentrate on learning the real 
causes of tuberculosis and how to avoid them and 
how to remove the effects of those causes if the 
causes have been permitted to be active. 


34 


CHAPTER IV 

Causes of Tuberculosis 

T N 1882 Dr. Robert Koch, of Germany, discovered 
a germ which was always present in cases of tu¬ 
berculosis, and which produced tuberculosis or 
tubercles when injected into animals along with 
food for the germs in the form of the germ culture. 
This he called the tubercle bacillus; and ever since 
all the medical men and books have stated that 
the cause of tuberculosis is this bacillus of Koch.. 
They have eulogized the man and anathematized 
the germ. For a long time they bent all their en¬ 
ergies toward killing the germ and tried all kinds 
of medicines and antitoxins for this purpose, all 
of which failed. Finally they had to admit that 
the germ is causative only when the soil is favor¬ 
able. Hence, we do not need to be afraid of the 
germ, but should concentrate on keeping free from 
“soil.” As long as the doctors bent all their en¬ 
ergies toward killing the germ they failed to cure 
the disease; but when they began to concentrate 
on building up the vitality through natural methods 
of treatment, letting the body take care of the germs, 
they began to be more successful. Now, while they 
still cling to various nefarious practises, they at least 
use fresh air and sunlight. 

The real cause of tuberculosis, therefore, is not 
the tubercle bacillus, but anything which reduces 
35 


TUBERCULOSIS 


the vitality or creates “soil.” But what is “soil”? 
Chiefly, by-products of normal and abnormal me¬ 
tabolism and digestion; but, also, poisons introduced 
directly into the body in the form of tea, coffee, 
tobacco, alcohol, drugs, serums, vaccines, etc. Tis¬ 
sues which are low in resistance and, therefore, 
abnormal to some extent in composition and func¬ 
tion are soil also for the germs. All this soil is 
created through wrong habits of living. By this 
I mean not especially robbery, murder, drunkenness, 
drug addiction, and dissipation, which most people 
think of as wrong habits of living; but also improper 
diet, lack of exercise, poor posture, wrong thinking, 
and many such things which the ordinary person 
never thinks of as habits at all, wrong or other¬ 
wise. As a matter of fact, these bad habits are 
more likely to produce tuberculosis than the ones 
first mentioned, because they lower the vitality and 
produce toxins slowly and insidiously so that the 
patient hardly realizes his condition. Then, too, 
these bad habits are much more prevalent; hence 
they cause a greater number of cases. Do not think 
of wrong habits of living as including only the well 
known “sins”; but as anything which interferes with 
the normal functions of the body, if it be no more 
than failing to respond to the call of Nature to 
evacuate the bowels or bladder. There is only one 
way to live and that is the right way; halfway meas¬ 
ures are seldom sufficient. 

Nothing is more likely to cause tuberculosis than 
lack of fresh air, yet this same lack may not be suffi- 
36 


CAUSES OF TUBERCULOSIS 


cient in itself always to produce the disease. It gen¬ 
erally requires a combination of causes; but lack of 
fresh air will undermine the entire organism so 
that other causes have a more powerful effect. A 
full supply of pure air is absolutely necessary to 
the purification of the blood stream and the main- 



Showing the circulation of air in a closed room where there is 
a fireplace. A fireplace is a valuable adjunct to a room but 
one should not depend entirely upon it. The window should 
be opened so as to get the maximum of fresh air. 

tenance of nervous energy, the two things upon 
which health chiefly depends. Pure air is necessary 
because any impurities of a solid nature, such as 
dust, lint, etc., will clog the respiratory passages 
and interfere with breathing, while impurities of 
a gaseous nature will enter the blood stream and 
poison it in spite of the purifying effect of the 
oxygen. 

Oxygen is to us the most necessary part of the 
air, for it is the most essential food of which we 

37 



























































TUBERCULOSIS 


partake. . When we breathe in it is taken up by the 
hemoglobin in the red corpuscles of the blood and 
is carried to all parts of the body to be used for 
building tissue and destroying waste matter. The 


destruction of waste 



An experiment which shows how 
the warm impure air goes out the 
top of a window and the fresh 
cool air comes in at the bottom 
when the sashes are open both 
top and bottom. 


accomplished by a process 
of combustion similar 
to burning, and this 
— 1 j produces heat, there- 

—L by helping to keep 

the body warm. 
Therefore, good air 
in abundance is nec¬ 
essary to the support 
of bodily heat. In 
fact, there is not a 
single function of the 
body which does not 
depend, to a large 
extent, upon oxygen. 
It is equally neces¬ 
sary, however, that 
carbon dioxide— 
which is produced by 
combustion of tissue 
or waste material 
and this is accom- 
out. Inhalation is 
n oxygen, while ex¬ 


in the body—be eliminated, 
plished when we breathe 
for the purpose of drawing 
halation throws off the carbon dioxide and other 
waste products. Thus we are constantly polluting 
the air; and unless there is a free circulation of it, 
38 




























CAUSES OF TUBERCULOSIS 


too large a proportion of the carbonic acid gas will 
soon accumulate. If the air we breathe is already 
impure this added pollution will soon render it 
wholly unfit for use, and if circumstances are suf¬ 
ficiently extreme we may smother to death. 

Unfortunately, we are constantly becoming more 



Illustrating two styles of window ventilators and the 
direction in which the air passes. In the window on the 
left a second ventilator could be employed at the top in 
bad weather. As operated, the window is lowered at the 
top, permitting the warm inside air to go out of the room, 
whereas the ventilator at the bottom permits the cool 
outside air to come in. 

and more indoor animals. We live indoors, work 
indoors, and frequently play indoors. Especially 
in the wintertime are people prone to avoid going 
out except when very necessary; and even then they 
will frequently go “out” in a closed car which is arti- 

39 






































TUBERCULOSIS 


ficially heated. The old-fashioned red flannel un¬ 
derwear is completely out of date. Most people 
in winter months usually are in some artificially 
closed and heated space. We are becoming hot¬ 
house plants. All this greatly increases the suscepti¬ 
bility to tuberculosis through lowering bodily re¬ 
sistance. If it were not for the improved systems 
of ventilation and the improvements in sanitation 
this indoor living would be even more serious than 
it is. But people who are out of doors a great 
deal may develop tuberculosis if they do not breathe 
deeply. It is not only necessary to be in the fresh 
air but to get the fresh air into you. Those who 
work at sedentary occupations soon develop the 
habit of breathing very shallowly. And sometimes 
they unconsciously may stop breathing for many 
seconds. This is followed by sighing and yawning 
—Nature’s method of making up for the previous 
lack of air. 

From a consideration of these factors you can 
see how easy it is to suffer from a lack of air al¬ 
most without knowing it. And even if plenty of 
air is secured it may not be pure air, because of the 
many sources of contamination, such as smoke and 
other gases from chimneys, automobile exhausts, etc. 
Life under modern conditions requires a high re¬ 
sistance. But if due attention is given to right liv¬ 
ing in every respect this can be attained and tu¬ 
berculosis avoided. 

The next most likely cause of tuberculosis is im¬ 
proper diet. We hear much of diet nowadays, and 
40 


CAUSES OF TUBERCULOSIS 


all sorts of information is broadcast as to what 
one should and should not eat. Many people be¬ 
come greatly confused and are afraid to eat many 
wholesome foods, with the result that they produce 
just as bad effects as though they ate everything, 
good and bad. This is not necessary, as a little 
common sense will enable one to adapt the funda¬ 
mental rules of diet to his own case. 



Another style of window ventilator which is fairly satisfactory. 
The chief drawback is the small opening available. This style 
is best suited to a room having many windows. 

The following dietetic errors are most likely to 
cause tuberculosis: First, the use of “refined,” de¬ 
natured, and imitation foods, such as white flour 
and its products, polished rice, degerminated corn 
meal, refined sugar and syrups, dried fruits which 
have been sulphured, overcooked vegetables, 
smoked or pickled foods, spices and condiments, 
tea and coffee—all of which lead to malnutrition or 
toxemia, or, usually, both. Only natural foods in 
as nearly as possible their natural state should be 
41 



















TUBERCULOSIS 


employed. Second, overeating, regardless of good 
or bad qualities. Third, eating when not hungry. 
Fourth, eating when worried or otherwise emo¬ 
tionally disturbed or when very tired—when di¬ 
gestion is certain to be imperfect. Fifth, insuf¬ 
ficient mastication. Sixth, the use of complicated 
dishes or menus, which make digestion very diffi¬ 
cult. Seventh, eating an excess of starches, sugars 
or proteins. I mention these because they are the 
elements of which most people are inclined to over¬ 
eat, and not because they have any specific action 
in producing tuberculosis or that they should be 
entirely avoided by all tuberculous patients. How¬ 
ever, whatever produces marked putrefaction or 
fermentation in the intestines favors the develop¬ 
ment and aggravation of tuberculosis. 

Lack of exercise is another possible cause of tu¬ 
berculosis. Exercise is very necessary for active 
circulation and elimination, and if it is not secured, 
the blood is inclined to stagnate, especially in the 
lungs, and there will be an accumulation of toxins 
to furnish food for germs. When regular exer¬ 
cise is not used there is no demand for strength, 
vitality, and resistance; and, consequently, these 
powers decline, for Nature is far too economical to 
supply anything for which there is no demand. 
Lack of exercise also leads to shallow breathing, 
for there is not the demand for oxygen and we soon 
get out of the habit of breathing deeply to supply 
it. Oxygen is best absorbed and most completely 
utilized when there is a strong demand for it, ere- 


CAUSES OF TUBERCULOSIS 


ated by active exercise. I have already explained 
how lack of air leads to tuberculosis. Lack of ex¬ 
ercise goes hand in hand with it. One may be 
doing considerable muscular work and still not be 
getting sufficient exercise, especially for the abdom¬ 
inal muscles. Work does not fully take the place of 
exercise, because work movements usually are lim¬ 
ited in extent. For the best psychological results 
it is necessary that the movements be free and 
carried to the limit of motion of the joints. Many 
people think that if they do muscular work they 
do not need exercise. But many a blacksmith has 
developed tuberculosis. Of course, I grant you 
that in such a case other factors necessarily would 
be present; but a little judicious exercise would have 
been very helpful in warding off the disease. 

But how about too much exercise? Is it not pos¬ 
sible to reduce the vitality in this way and so lead 
to tuberculosis? Of course it is; but practically 
no one ever does it. Most people have to be driven 
to exercise by their urgent need of it. A few over- 
enthusiastic converts to the cause of Physical Cul¬ 
ture may overexercise for a time, but they usually 
soon discover their mistake before any damage is 
done. There is far more danger of too little than 
too much exercise. The bad results sometimes 
noticed when working long hours or doing consid¬ 
erable exercise are usually a result of lack of sleep, 
worry, improper diet, or some other factor. This 
is proved by the fact that a reduction in the amount 
of work or exercise fails to produce complete re- 
43 


TUBERCULOSIS 


suits, but when more sleep is secured and the other 
habits of living are corrected the person feels bet¬ 
ter and is usually able to do as much or more than 
he was doing. 

Rest and sleep are necessary, not only to bal¬ 
ance exercise but to give the body an opportunity 
to recuperate in every part. Lack of rest and sleep 
very quickly will reduce the vitality and resistance. 
All during the day we are using up energy and 
tissue and the body has little opportunity to make 
up the loss as long as we are active. Complete 
relaxation is nearly as good as sleep for repairing 
and rebuilding of tissue, but not so good for the 
recuperation of nervous energy. So both are neces¬ 
sary if we would avoid that tired-out feeling which 
is often a forerunner of tuberculosis. Most people 
easily can judge for themselves when they are not 
getting sufficient sleep. But sometimes it is possible 
to accustom the body to going without a certain 
amount of rest so that no immediate symptoms are 
felt; but there is a gradual reduction in vitality 
which is particularly dangerous because it is un¬ 
noticed. It is well, therefore, to secure the regula¬ 
tion eight hours of sleep fairly constantly. In any 
case, never make the mistake of thinking that you 
can burn the midnight oil for an indefinite period 
and not have to pay the piper. We often find tu¬ 
berculosis developing after a long period of special 
work, mental strain, or other factors involving a 
loss of sleep. 

I have already said that tuberculosis is chiefly 
44 


CAUSES OF TUBERCULOSIS 

due to internal filth. But external uncleanliness 
may also be a factor. However, the bad effects of 
insufficient bathing in adding to the probability of 
the development of tuberculosis arises not so much 
from the resulting uncleanliness as from lack of 
skin activity. Of course, dirt interferes with skin 
activity, but so does clothing. Civilized people wear 
clothing so much that the skin seldom if ever gets 
the stimulation of the air, sunshine, and friction of 
external objects which is common in a state of 
nature. Thus the skin becomes inactive unless 
special measures are taken to see that it has an op¬ 
portunity to work freely. But few people take air, 
sun, or friction baths; and it is not to be wondered 
at that their skins are sluggish in action and clogged 
with waste material from inside the body so that 
further elimination is seriously restricted. 

Lack of sunshine on the skin is a prominent 
cause of tuberculosis. When the heat and light of 
the sun are lacking, elimination in the form of 
perspiration is much reduced. More energy is re¬ 
quired to metabolize food products for the main¬ 
tenance of body heat because not enough heat is 
secured from the sun. The food itself cannot be 
so well utilized by the body, as the sun produces 
vitamins in foods, which are necessary to metabo¬ 
lism. The antiseptic action of the sunlight is lost, 
and it is a rather serious loss. I have already told 
you how sunlight kills tuberculosis germs. Dr. 
Saleeby, in his book “Sunlight and Health,” says 
that a properly aired and lighted skin becomes 


TUBERCULOSIS 


r 


immune to acne and incapable of being vaccinated. 
The sun is our chief source of nervous energy; but it 
must reach the skin for best results. Lack of sun¬ 
light, therefore, decreases resistance and favors the 
production of “soil,” so that the tubercular germs 
are given opportunity to come and set up house¬ 
keeping. 

Shutting off the air from the skin by continually 
wearing clothing may predispose to tuberculosis the 
same as may lack of air in the lungs, for the skin 
breathes to a certain extent like the lungs. Most 
people do not realize how their skin is suffering 
for lack of air until they take air baths for a time. 
Then they feel so much better that they realize 
what they have been missing. 

Another source of skin stimulation missed by 
many people is cold water. The exclusive use of 
hot water for bathing leads to anemia of the skin 
and of the blood and to lack of resistance to changes 
of temperature as well as other viscissitudes in the 
environment. Too many hot baths may seriously 
weaken the entire organism so that it becomes very 
susceptible to any wasting disease, such as tubercu¬ 
losis. Cold water toughens and hardens the skin, 
stimulates the production of nervous energy, and 
builds reactive power, generally rendering the body 
more resistive to all diseases. Omission or insuf¬ 
ficient use of cold water, therefore, may be quite a 
prominent cause of tuberculosis. 

Another factor which must be considered is the 
posture. If one allows the shoulders to droop the 

46 


CAUSES OF TUBERCULOSIS 

chest immediately is constricted and free breathing 
is impossible. Even the inclination to breathe deeply 
is destroyed. You can readily see how this might 
be a cause of tuberculosis when you remember what 
I have said of the importance of fresh air and deep 
breathing. Drooping shoulders also produce ab¬ 
normal pressure on the abdominal organs, inter¬ 
fering with digestion, assimilation, and bowel 
evacuation. There is always a history of an inter¬ 
ference with these functions in every case of tu¬ 
berculosis. There is also the mental effect of 
improper posture to consider. Carelessness in this 
respect leads to lack of confidence, courage, de¬ 
termination, and initiative. It renders one suscepti¬ 
ble to worry, fear, and all negative thoughts and 
influences. These things soon interfere with every 
function of the body. 

I wish to emphasize especially the effect of wrong 
thinking in producing tuberculosis. Fear is the basis 
of practically all destructive emotions, such as worry, 
anger, jealousy, hate, etc. These are called destruc¬ 
tive emotions because they actually destroy health 
and happiness. They produce poisons in the body, 
waste nervous energy, give rise to tension, and 
greatly interfere with every function of the body, 
perhaps especially digestion and assimilation. This 
means starvation in the midst of plenty; and starva¬ 
tion means susceptibility to disease, especially tuber¬ 
culosis. Fear of the disease is very likely to bring it 
into manifestation. When we fear a thing we think 
of it quite constantly or frequently; we picture our- 
47 


TUBERCULOSIS 


selves as being attacked by or afflicted with the thing 
feared; and thus we open our minds to all the in¬ 
fluences which tend to bring about the disease. 

If you continually think of tuberculosis you will 
create in the subconscious mind a model of your¬ 
self suffering with the disease. This will be worked 
out into manifestation in accordance with mental 
laws, especially since fear also inhibits all the func¬ 
tions of the body, and thus prepares the soil by 
producing enervation and toxemia. Many a person 
who feels that he has always lived right in a phys¬ 
ical way and cannot understand why he should have 
developed tuberculosis will find the answer if he 
will investigate his habits of thinking. It is really 
amazing to compare with our positive thoughts the 
number of negative thoughts we think in a day. 
It reminds one of the well known comparison of 
the mountain and the mole hill, positive thoughts 
being the insignificant mole hill. Another way of 
looking at this matter is that one cannot think right¬ 
ly and live wrongly—he cannot think rightly in 
every respect and live wrongly in any respect— 
because thought always precedes action. If the 
truth were known or measureable, I believe wrong 
thinking would rank as a cause of tuberculosis fully 
as high as the M. D.’s like to place the tubercle 
bacillus. 

It is really wrong habits of cooking which give 
rise to the use of tobacco, alcohol, drugs, tea, coffee, 
and similar poisons, all of which create soil for 
tuberculosis germs. A young man thinks he has to 
48 


CAUSES OF TUBERCULOSIS 

smoke because the other fellows do; and a young 
woman may think she has to smoke to be smart and 
modern. In time they become addicted to this habit 
and think they have to smoke to live, whereas 
every indulgence leads them farther on the road to 
physical ill health. The use of tobacco naturally 
affects the lungs very quickly and renders one par¬ 
ticularly liable to respiratory diseases. The lungs 
were meant to accommodate fresh air and not smoke, 
which is proved by the fact that choking results 
when smoke is introduced, at least until the body 
learns to put up with it through habitual abuse. 
Even then an unusual amount will give rise to chok¬ 
ing. The habitual smoker will complain loudly if 
subjected to smoke from a furnace, an engine, or 
an automobile exhaust; yet he never stops to think 
that his tobacco smoke is equally harmful to him 
and equally objectionable to other people. Tobacco 
is supposed to kill germs, and many medical doctors 
condone its use by tuberculous patients for this 
reason. Perhaps it does kill germs; but if it does 
it will most certainly also kill the body cells and 
thus prevent recovery from tuberculosis and ulti¬ 
mately bring about the death of the patient. All 
too often doctors who know better will permit the 
use of tobacco because they themselves do not wish 
to give up smoking and have no way of justifying 
their use of it to their patients. 

The bad effects of alcohol are too well known 
to need discussion. Statistics prove that persons 
who use alcohol are especially liable to tuberculosis. 

49 


r 


TUBERCULOSIS 

It is a prominent cause because it poisons and de¬ 
generates the entire body. Drugs and medicines of 
all kinds, including tea and coffee, which are really 
drugs, predispose to tuberculosis in the same way, 
but in varying degree. Laxatives, when long con¬ 
tinued, are especially liable to weaken the digestion 
and assimilation; and interference with these func¬ 
tions prevents proper nutrition of the body. Un¬ 
dernutrition is notoriously present in practically all 
cases of tuberculosis. Tea and coffee are especially 
harmful because the bad effects are not immediately 
apparent and many people weaken their resistance 
without realizing it. They develop some chronic 
disease and then wonder how it happened. While 
it may be possible for some people to use the poisons 
mentioned in this paragraph for a considerable 
period of time without apparent ill effects, the re¬ 
sults are there just the same and will appear when 
least expected. You cannot cheat Nature and get 
away with it—remember that. 

While I am on the subject of drugs I must men¬ 
tion vaccination and inoculation. These a-re a curse 
of modern life, particularly since they are so often 
compulsory or nearly so. Nothing will predispose 
more quickly to tuberculosis than vaccination for 
smallpox. Introduction of a poison directly into 
the body without passing through the digestive tract, 
as is done in vaccination and inoculation, robs the 
body of the opportunity to protect itself and calls 
for unusual forms of elimination. Many cases 
of tuberculosis have traced the first failure of their 
50 


CAUSES OF TUBERCULOSIS 


health to vaccination or inoculation of some kind. 
They may not have had any acute symptoms (usu¬ 
ally it would have been better if they had) ; but 
their health gradually failed, their resistance low¬ 
ered, they lost weight and developed a cough, and 
on consulting a doctor tuberculosis was found. Does 
the doctor say it came from vaccination? By no 
means. The tubercle bacillus is to blame! But 
any one who will study both sides of the vaccination 
question and especially the history of tuberculous 
patients, will know which is the truth. I really 
should have placed this matter nearer the top of 
the list in considering the causes of tuberculosis, 
since it holds such a prominent position among all 
causes. 

Vaccination is supposed to prevent disease, but 
it never does. Inoculation is done sometimes for 
prevention and sometimes for cure; but it never 
does either. When given for cure it may sometimes 
produce a cessation of symptoms. But this is sup¬ 
pression, not cure. The suppression of acute dis¬ 
ease, especially colds, “flu,” pneumonia, bronchi¬ 
tis, typhoid, etc., by medicines or inoculations is 
often a cause of tuberculosis. Many patients will 
tell you that their tuberculosis followed a severe 
cold or an attack of “flu.” As a matter of fact it 
was not these diseases which produced the trouble, 
but the treatment which was used to suppress them. 
Suppression does not remove toxins; and as long 
as these remain there is bound to be further trouble. 
Chronic conditions, like asthma, diabetes, syphilis, 
51 


TUBERCULOSIS 


and cirrhosis of the liver, may also be followed by 
tuberculosis. But here again it is the causes of 
these conditions and the treatment used which are 
chiefly responsible for the lung disease. Whenever 
there is a chronic condition, such as those men¬ 
tioned, there always is a considerable reduction in 
the vitality, and under such circumstances the per¬ 
son is very open to “infection” by germs. 

Finally, as cause of tuberculosis we have the 
influence of what is usually called environment. This 
includes general living conditions, occupation, cli¬ 
mate, etc. I have called attention to the bad effects 
of indoor life, poor housing, overcrowding, lack 
of sanitation, and poverty. Many people are in 
occupations which may help to cause tuberculosis 
by subjecting them to irritating vapors, impure air 
and close confinement. I do not say that such occu¬ 
pations in themselves will produce tuberculosis; 
but they create such an unfavorable environment 
as to render it more likely to develop. If the worker 
lives rightly in every respect it should be possible for 
him to continue his occupation without harm. 

Climate has really little to do with causing tuber¬ 
culosis, but it is more difficult to avoid this disease 
in a warm damp climate. In such a climate one 
is inclined to become enervated, elimination is re¬ 
tarded, and sanitation is more difficult. Germs 
thrive in such an environment. Nevertheless, tu¬ 
berculosis is not confined to those parts of the world 
having such a climate, nor does every one in such 
a climate have the disease. There must be other 
52 


p 


CAUSES OF TUBERCULOSIS 


causes present before climate will become a factor. 

In most chronic cases of tuberculosis there is no 
particular exciting cause unless the germ should be 
so considered. There is usually a gradual reduc¬ 
tion in the vitality and a gradual increase in the 
amount of toxins, until inflammation results; and 
then, if the germ is contracted or develops, the 
characteristic symptoms of tuberculosis appear. In 
acute tuberculosis, however, the symptoms usually 
manifest after a period of unusual mental or phys¬ 
ical strain, after a severe acute disease not properly 
treated, or after particularly abandoned dissipation, 
or following exposure to unusual extremes of 
weather. The exciting causes, however, are of little 
importance, as it is the habits of living and environ¬ 
ment which really make the disease necessary and 
which prepare the “soil” for the germs. 

When we consider how most people live, and 
how many opportunities there are in civilized life 
for reducing vitality and interfering with function, 
the wonder is that there is not more tuberculosis. 
We learn from the great number who escape tuber¬ 
culosis how the body always does its best to keep 
normal, how kind and forgiving Nature is even 
though we sometimes may think her harsh, and 
how persistent is Life. We learn also that, since 
these things are so, recovery from tuberculosis is 
easily possible if one will give Nature a chance. It 
should especially teach us the importance of preven¬ 
tion by right living, for it is always easier to prevent 
than to cure. 


53 


CHAPTER V 

Symptoms of Tuberculosis 

r I V HE characteristic lesion in cases of tubercu- 
A losis is the tubercle. This was described in 
the chapter on “Nature of Tuberculosis.” The 
tubercle may be said to be a symptom of all cases 
of tuberculosis, but the other symptoms vary con¬ 
siderably in accordance with the degree of inflam¬ 
mation and its location. Certain general symptoms, 
such as progressive loss of weight and strength, 
anemia, afternoon fever, and night sweats, are also 
frequently associated with all cases, regardless of 
location. But these do not always appear, some 
cases having few if any symptoms and presenting 
the appearance of fair health. Much depends on 
the bodily resistance and the extent to which the 
disease has progressed. In other words, by no 
means are all cases strictly typical; yet most cases 
fairly closely approximate the typical, so that a de¬ 
scription of these forms will be adequate for giving 
the reader an idea of the extent of his condition 
and what is going on in the body. For symptoms, 
remember, are not the disease, but only manifesta¬ 
tions of the body’s unusual activities in eliminating 
the real disease, toxemia. 

ACUTE TUBERCULOSIS 

Acute cases of tuberculosis are by no means so 
frequent as the chronic; and this is fortunate, for 
54 


SYMPTOMS OF TUBERCULOSIS 

they are usually more fatal. However, if one has 
such a case there is no need to despair, as con¬ 
fidence and the right treatment will often work 
miracles. The acute cases usually occur under fif¬ 
teen years of age, because children are more in¬ 
clined to acute diseases of all kinds on account of 
their more rapid metabolism. Such cases are sup¬ 
posed to be due to the breaking down of a tubercle 
or a caseating (degenerating into cheese-like sub¬ 
stance) group of tubercles so that the germs are 
quickly and widely disseminated throughout the 
body, giving rise to tubercle formation in practi¬ 
cally all the organs. However, such a widely spread 
infection could occur only when there is a greatly 
reduced vitality and resistance coupled with a heavy 
toxemia. 1 herefore, the causes mentioned in the 
last chapter are more to blame than the tubercle 
degeneration. 

The onset of the disease may last for a few r days 
or be extended over several weeks. It is often mis¬ 
taken for typhoid fever, but can be distinguished 
from this disease by the fact that there is no ab¬ 
dominal rash, hemorrhage from the bowels is rare, 
as a beginning symptom, and there are moist rales 
in the lungs. There is, however, a quite rapid loss 
of weight and strength, together with cough, rapid 
respiration, and feeble pulse. At first the mucus 
raised is white and frothy, later it becomes thick 
and yellow. The temperature is quite irregular, 
often making sudden jumps to as high as 104 de¬ 
grees, but tending to the usual form of morning 


r 


TUBERCULOSIS 

sub-normal and afternoon elevation above normal. 
As the condition progresses and the fever becomes 
higher there may be delirium or convulsions fol¬ 
lowed by stupor. Every effort should be made to 
prevent the symptoms developing to this stage. 
There may be quite a variety of other symptoms, 
depending upon the degree to which each organ is 
affected. The covering membranes of the brain, 
intestines, larynx, etc., all may be affected, giving 
rise to the symptoms to be described hereafter un¬ 
der the special headings. 

Sometimes the acute cases may start like pneu¬ 
monia, with sudden onset, quite high fever, and 
considerable pain in the chest. The fever is not 
so constant, however, and in a few days it usually 
is easy to tell that something more than pneumonia 
is present. The usual general symptoms, as noted 
above, also appear; but the inflammation is largely 
confined to the lungs or the lungs and intestines. 
These cases are called quick consumption or gallop¬ 
ing consumption, in distinction from the acute 
general cases where most of the organs of the body 
are affected at once. In all acute cases very prompt 
treatment of the proper kind must be adopted if 
good results are to be secured. 

CHRONIC PULMONARY TUBERCULOSIS 
The chronic causes of tuberculosis generally af¬ 
fect the lungs. If other parts are diseased it often 
is in addition to the lungs. Chronic pulmonary tu¬ 
berculosis may begin like an acute case and gradually 
56 


SYMPTOMS OF TUBERCULOSIS 


subside to the chronic stage; but the majority of 
cases come on slowly so that the patient often is 
not aware of his trouble until it is fairly well de¬ 
veloped. Chronic lung cases are usually divided 
into three classes: incipient, moderately advanced, 
and advanced. These are defined as follows, the 
symptoms mentioned being the maximum allowed 
for each class: 

Incipient. Slight or no general constitutional 
symptoms, such as loss of weight and strength, 
shortness of breath, etc. Slight or no increase in 
temperature or pulse rate, expectoration small or 
absent, tubercle bacillus sometimes present and some¬ 
times not. The lung involvement is limited to a 
slight infiltration in one or both apices or a small 
part of one lobe. There should be no tuberculous 
complications. 

Moderately advanced. No marked impairment 
of function, either local or constitutional, but still 
more impairment than in an incipient case. There 
is marked infiltration of the lungs, but no cavity for¬ 
mation. There should be no serious tuberculous 
complications, such as intestinal or laryngeal in¬ 
volvement. 

Advanced. Marked impairment of function, both 
local and general, such as pain, difficulty in breath¬ 
ing, loss of weight and strength, fever, night sweats, 
etc. Extensive localized infiltrations or consolida¬ 
tions in the lungs, or disseminated areas of cavity 
formation, or serious tuberculous complications, 
57 


TUBERCULOSIS 


such as involvement of other parts of the body, 
marked hemorrhage, acute pleurisy, etc. 

In practically all cases there is a history of grad¬ 
ual loss of weight and strength. The patient finds 
that he becomes easily tired, and this increases to a 
point of chronic fatigue. Sleep does not seem to 
refresh fully, and general recuperation is slow. 
Often there are recurring colds, or catarrh, or bron¬ 
chitis. A chronic cough appears, which is especially 
troublesome at night and early in the morning, and 
there is increasing shortness of breath. A slight 
pleurisy, coming on gradually and showing a ten¬ 
dency to recur and become chronic, is suspicious of 
tuberculosis. Constipation practically always is 
present; but this should be considered more as a 
cause than as a symptom of tuberculosis. Finally 
the cough increases, often becoming quite distress¬ 
ing; the expectoration becomes more profuse and 
changes from frothy white to thick yellow or green¬ 
ish; the cheeks are flushed in the afternoons, and 
there # are night sweats. If the patient has not thus 
far been examined these symptoms are usually suf¬ 
ficient to send him to a doctor, and the tuberculosis 
then is discovered. 

If the condition is neglected the symptoms become 
increasingly worse, the fever rises higher, the sweats 
become more profuse and exhausting, and the loss 
of strength is such that ordinary activities become 
impossible. At any time during the appearance of 
these symptoms there may be lung hemorrhage. 
This is slight at first, the mucus being merely 
58 


SYMPTOMS OF TUBERCULOSIS 

streaked with blood, and it appears only after vio¬ 
lent coughing. In more advanced cases the hemor¬ 
rhages become more profuse, sometimes mounting 
to several ounces, and even slight coughs may in¬ 
duce them. On the other hand, some of the most 
severe cases do not have hemorrhages, so this is not 
a constant symptom. Also, some cases may not 
have fever or noticeable cough until the condition is 
quite advanced. But generally this is only in those 
patients who are taking fairly good care of them¬ 
selves, in consequence of which the progress of the 
disease is retarded. 

The degree of pain varies considerably. Some 
may have practically no pain and only late in the 
disease, while others notice this symptom quite early. 
Usually it first appears between the shoulder blades 
or just below them, but it may be present in one or 
both sides. Sometimes there is merely a feeling of 
tightness without actual pain. The degree of pain 
does not indicate the extent of the disease. Diges¬ 
tive disturbances are frequent, and there is loss of 
appetite, especially if the patient resorts to over¬ 
eating in an effort to gain weight. There may be 
occasional attacks of diarrhea, even if the intestines 
are not tuberculous. The coughing interferes with 
sleep, and insomnia may develop. 

The symptoms which appear on physical exami¬ 
nation are sunken chest, hollow cheeks, hectic flush 
(small bright pink areas on the cheeks), fever of 
99 to 102 degrees or occasionally even higher dur¬ 
ing the afternoon and evening, descending to 97 or 
59 


TUBERCULOSIS 


97.5 in the morning, rapid pulse, even when fever 
is not present, various adventitious (incidental) 
sounds in the chest, anemia, and the bacillus tubercu¬ 
losis in the sputum. The abnormal sounds in the 
lungs are usually heard at the apices (tops) of the 
lungs, but may be heard over the bases of the lungs 
in the back. They are best heard when the patient 
coughs. 


LARYNGEAL TUBERCULOSIS 

When the larynx becomes affected symptoms ref¬ 
erable to that organ develop. It is seldom that 
the larynx is affected alone. In most cases laryngeal 
tuberculosis is secondary to lung infection. The 
early symptoms include hoarseness and pain upon 
swallowing hot or cold liquids or hard substances. 
A chronic hoarseness is always suspicious of tuber¬ 
culosis, even though it may be due to simple laryn¬ 
gitis. If the larynx is really tuberculous the hoarse¬ 
ness increases, and there are times when the voice 
is lost entirely. The pain on swallowing also in¬ 
creases, until in time it becomes quite severe. Some¬ 
times it is worse when swallowing liquids and some¬ 
times when swallowing solids. The pain may be 
constantly present even when not swallowing, and it 
may interfere seriously with sleep. The constant 
irritation in the throat leads to the secretion of 
large quantities of mucus which must be eliminated 
constantly. This coughing and rasping of the throat 
are not only painful but tend, in combination with 
the tuberculous condition, to produce local swelling. 

60 


SYMPTOMS OF TUBERCULOSIS 

This may interfere with breathing, especially when 
lying down. Upon examination the cartilages of the 
larynx are found to be swollen, especially the aryte¬ 
noids and epiglottis. These parts may be ulcer¬ 
ated, also, or the vocal cords may be affected. When 
there is extensive ulceration there may be consider¬ 
able destruction of tissue. Occasionally in very se¬ 
vere cases the epiglottis may be almost entirely de¬ 
stroyed. If neglected, the condition may become so 
bad that swallowing and breathing are extremely 
difficult, in which case there is danger of asphyxia¬ 
tion, as well as of starvation. There is no reason 
why these symptoms should develop, however, if 
proper treatment is employed. 

INTESTINAL TUBERCULOSIS 
If the vitality is especially lowered, some of the 
causative factors still are left operative, and if the 
patient swallows the sputum off and on instead of 
expectorating it, the intestines may become infected. 
Sometimes the intestines are infected in other ways, 
even before the lungs are involved; but in most 
cases where the intestines are diseased the lungs first 
were diseased. This is a serious combination, and 
there is danger of the peritoneum or lining of the 
abdomen also becoming affected. 

The first symptoms usually are pain, intestinal gas 
and diarrhea. The appearance of these symptoms 
does not necessarily indicate that the intestines have 
become tuberculous, as they may be caused by im¬ 
proper diet. If the diarrhea is persistent, how- 
61 


TUBERCULOSIS 


ever, if the pain increases until it becomes intense 
and the abdomen becomes swollen and distended, 
one can assume that intestinal tuberculosis is pres¬ 
ent, especially if the lungs are known to be affected. 
Other symptoms which may appear are dry, harsh 
skin, dilated pupils, and hemorrhage from the 
bowels. Fever generally is high in these cases, and 
sweating is profuse. The latter may give rise to 
an eruption of whitish vesicles on the skin as a result 
of retention of the perspiration in the glandular 
ducts or between the layers of the epidermis. The 
patient becomes very much emaciated, because the 
food is not properly digested or retained long 
enough for absorption and because of the profuse 
sweating which depletes the body of water. All the 
general symptoms are correspondingly increased. 
Very careful treatment will be required to check the 
disease when it has affected the intestines. 

GLANDULAR TUBERCULOSIS (TUBERCULOUS 
ADENITIS) 

Tuberculosis of the glands often occurs independ¬ 
ently of pulmonary tuberculosis. If the lungs are 
affected, some of the glands, especially about the neck 
and chest, almost certainly will be diseased, but sel¬ 
dom to the extent that special glandular symptoms 
will develop. The trouble in the lungs seems to give 
sufficient eliminations so that the glands are not so ac¬ 
tively or severely affected. Glandular cases may not 
be accompanied by general symptoms when the lungs 
are not affected. Usually, however, there is some 
62 


SYMPTOMS OF TUBERCULOSIS 

degree of loss of weight and strength, and various 
digestive disturbances. Fever usually is slight or 
absent. There seldom is coughing, and the lighter 
cases may appear to be in good health except for 
the swelling of the glands. This swelling comes on 
gradually with little or no pain. As the swelling 
increases, however, there is tenderness upon friction 
or pressure. If the condition is not checked the 
glands begin to suppurate (form pus), and abscesses 
and fistulas are formed. A fistula may appear as a 
drain for the pus from the gland, even without defi¬ 
nite abscess formation. There is a constant slight 
discharge, and the openings usually are very chronic 
and hard to heal. Acne and similar skin eruptions 
also may develop. When there is much suppuration 
the general symptoms, including fever, often will 
appear; and in any case the general health soon will 
show the effects. 

The glands of the neck, chest, and axillae (arm- 
pits) most often are affected, but glands of part of 
the body may be, including such glands as the tes¬ 
ticles. When the latter are affected the parts be¬ 
come swollen and the spermatic cord and other tis¬ 
sues around and supporting the testicles become 
thickened. The skin is adherent to the glands. The 
trouble usually starts gradually with but little pain; 
but if it advances there may be considerable pain, 
with abscess formation and discharge of pus. 

In children, tuberculosis of the glands often is 
called scrofula, though this term gradually is falling 
into disuse in favor of tuberculous adenitis. The 
63 


TUBERCULOSIS 


symptoms are much as described above, except that 
suppuration practically always occurs and ulcers fre¬ 
quently form. There may be sore eyes, running 
ears, and skin eruptions. The muscles are soft and 
flabby. If the condition is present to any marked 
extent there usually is fever, since children are in¬ 
clined to acute symptoms, in which fever usually 
is prominent. In such cases emaciation also occurs, 
and there is a definite anemia. Often the glands in 
the lining membrane of the back of the abdomen 
become infected, producing a condition called tabes 
mesenterica. These cases exhibit wasting of the 
limbs and trunk, with great swelling of the abdomen 
from gas. This naturally causes considerable pain. 
Diarrhea with offensive stools is present, even if the 
intestines themselves are not tuberculous. If the 
disease spreads, the membrane in the front of the 
abdomen may become affected, giving rise to uneven, 
tender, and painful swellings, which can be easily 
felt under the skin. Generally it is only the cases 
which have a very poor physical heredity and very 
poor health environment which develop to this stage. 
Most cases of tuberculous adenitis in children are 
limited to some swelling and suppuration of the 
glands about the neck. 

BONE TUBERCULOSIS (TUBERCULOUS OSTEITIS) 

Bone tuberculosis generally occurs independently 
of the pulmonary variety. Children most often are 
affected. Either the shafts of the bones or the joints 
may be involved. Often the disease spreads from 
64 


SYMPTOMS OF TUBERCULOSIS 


the bones to the joints. The bones adjacent to the 
hip, knee, and elbow are the regions most often at¬ 
tacked. When the joints are involved the most com¬ 
mon sites, in children, are the hip, knee and ankle. 
In adults the wrist, elbow, and shoulder may be 
involved. The earliest indications of tuberculosis 
of the bones may be seen in the muscles. It will be 
noticed that they are gradually wasting away, espe¬ 
cially just above and below the point where the bone 
is affected. Spasm of the muscles may be noticed, 
and rigidity usually is present when the spine or hip 
is affected. Deformity may result because of the 
unequal pull of the muscles, the atrophied ones being 
unable to balance the normal tension of those un¬ 
affected. There naturally is considerable lameness, 
the parts are easily tired, and light pressure causes 
a sudden severe pain. When there is no pressure 
pain may be absent or slight. 

The disease usually is divided into three stages: 
(i) Stage of localized infection where only the 
bone is involved; (2) stage of involvement of the 
entire joint, including the ends of the bones and the 
ligaments; (3) stage of destruction of the parts and 
the external discharge of pus. 

Of the joints, the hip is most commonly affected, 
and a description of the symptoms of “hip-joint dis¬ 
ease” will serve as an example of those occurring 
when other joints are affected. 

In the first stage there is very little constitutional 
disturbance. The chief symptoms are limping, slight 
flexion of the affected hip joint, swelling of the 
65 


TUBERCULOSIS 


glands in the groin of the affected side, pain, which 
often is referred to the knee, and wasting of the 
muscles of the thigh and buttocks. In the second 
stage all these symptoms are intensified, and there 
is grating of the joint and, frequently, abscess for¬ 
mation. When an abscess appears the general 
health begins to show signs of failing. There is 
loss of appetite, paleness, irritability and, often, 
slight temperature. Sometimes diarrhea occurs. 
Upon falling to sleep, the patient is likely to awaken 
suddenly with a loud cry. This is because of the 
sudden pain induced by rubbing of the sensitive dis¬ 
eased joint surfaces as the tense muscles relax. In 
the third stage the general symptoms are still fur¬ 
ther increased, and greater deformity develops. 
The thigh is both fixed and adducted, so that the leg 
apparently is shortened. The joint may become en¬ 
tirely dislocated. With these extensive changes the 
pelvis naturally is affected, being tilted upward and 
backward and causing a forward curve of the spine. 
On account of the shortening of the leg there also 
is a double lateral curvature of the spine. If proper 
treatment is adopted so that recovery ensues, the 
inflammation subsides; and as the pus and debris 
are absorbed ankylosis fixation of the joint occurs. 
Permanent deformity results, but the patient lives. 
There are few cases of this disease where there is 
not some resulting deformity unless proper treat¬ 
ment is adopted very early. If the condition is not 
properly treated the continued inflammation de¬ 
stroys the joint, and the general health is so affected 


SYMPTOMS OF TUBERCULOSIS 


that some other part of the body becomes tubercu¬ 
lous—a combination that is too much for the vitality, 
and death results. However, most cases recover, 
as children respond readily even to partly rational 
treatment. 

Tuberculosis of the spine is a frequent form of 
bone tuberculosis. The first symptoms are a sense 
of weakness, with a disinclination to move the back. 
This develops until the spine is held rigid, and at 
this time there is pain in various parts of the body 
due to irritation of the spinal nerves, and also ten¬ 
derness upon pressure over the part affected. The 
pain is worse after standing and may disappear en¬ 
tirely when lying down. The rigidity of the back 
leads to a peculiar stiffness in walking. The patient 
is usually averse to any kind of activity. If the dis¬ 
ease is allowed to progress, suppuration sets in, with 
abscess formation; and there are the usual general 
constitutional symptoms of tuberculosis as already 
described. The pus from the abscess usually travels 
some distance before it comes to the surface of the 
body. Thus the opening may appear in a loin or in 
a groin; or, if the upper spinal vertebrae are af¬ 
fected, in the pharynx. With the appearance of 
suppuration there naturally is destruction of the tis¬ 
sues, not only of the bone but of the cartilages be¬ 
tween and about the bones. 

With the destruction of the tissues and the forma¬ 
tion of pus, pressure against the nerves and spinal 
cord will develop and paralysis will occur. The 
location and degree of the paralysis will depend 
67 


TUBERCULOSIS 


upon the location and degree of the inflammatory 
process. Loss of motion practically always precedes 
loss of sensation. The paralysis generally comes on 
gradually, affecting the limbs first and making walk¬ 
ing and arm movements awkward and difficult. In 
advanced cases there usually is severe pain, with 
spasm, rigidity and wasting of the muscles. If the 
upper spine is affected there may be interference 
with breathing and swallowing, and there is a fre¬ 
quent dry cough. If the middle spine is affected 
there often is a sensation as of a tight band about 
the body. When the trouble is in the lower spine 
there is irritation of the bowels and bladder, with 
frequent stools and urination. 

The extent of the deformity depends upon the 
stage of the disease. Naturally, there is no deform¬ 
ity at first. As the disease progresses, however, and 
the bones and cartilages are destroyed, the spine 
sinks forward and the processes on the backs of 
the vertebras project backward, giving a humped 
appearance. In order to make up for this curve 
other curves are developed above and below the af¬ 
fected part so that the body may still be held up¬ 
right. This deformity is most marked when the 
disease affects the thoracic region. In this case, also, 
the chest will be compressed and the movements of 
the lungs and heart impaired. When the cervical 
region is affected and the destruction of tissue is 
-extensive the head may be displaced forward so that 
it appears to be in front of the spine. The most 
common part of the spine to be affected is the junc- 
68 


SYMPTOMS OF TUBERCULOSIS 


ture of the thoracic and lumbar regions, or the 
upper part of what is familiarly known as the 
“small” of the back. Here the bodies of the verte¬ 
brae are large and more subject to strains and in¬ 
juries which may weaken them and render them sus¬ 
ceptible to inflammation when other conditions are 
favorable. 

When proper treatment is adopted healing may 
occur at any time. If there has been more than a 
slight destruction of tissues some ankylosis (con¬ 
solidation of a joint) is bound to develop. This is 
necessary in order to maintain the strength of the 
spine. The pus and debris formed when the bones 
are being destroyed by the inflammatory process dry 
up and are absorbed as the causes are removed; 
or sometimes they are discharged externally, after 
which the sinuses through which they discharge usu¬ 
ally close up. The remaining parts become welded 
together by the formation of new bone, and bony 
splints are produced as needed. In all except the 
lighter cases there is certain to be some deformity; 
but if proper treatment is adopted early this need 
not be extensive nor such as to interfere with normal 
health and activity. 

SKIN TUBERCULOSIS (LUPUS VULGARIS) 

The skin cases of tuberculosis often vary consid¬ 
erably in their manifestations, but there always is 
the characteristic tubercle. These cases usually oc¬ 
cur independently of lung infection. Most cases 
begin before the age of twenty, and often before 
69 


TUBERCULOSIS 


the age of ten. The parts affected usually are the 
nose, cheeks, and ears; but the entire body surface 
may be involved, and occasionally the mucous mem¬ 
branes, or the cartilages of the nose, mouth, etc. 
There usually are no symptoms except those which 
can be seen upon the skin, though in advanced cases 
there may be some pain, and usually the general 
health is affected as in all cases of tuberculosis. 
Generally the first symptom noticed is an eruption 
of very small reddish, yellowish or brownish soft, 
flat lumps. These may be close together and ar¬ 
ranged in various patterns or they may be widely 
disseminated. These little lumps gradually grow to 
the size of a pea or larger and become harder. 
Finally they coalesce into irregularly shaped, dull 
red, raised soft patches. They may go no further 
than this, especially if proper treatment is adopted. 
If such treatment is not employed the tubercles may 
degenerate and form ulcers. The disease is usually 
very chronic, and when healing does result there is 
considerable scar formation. 

Before closing this chapter I want again to call 
attention to the fact that the symptoms are not the 
disease, but merely the signs of the body’s activities 
by which it undertakes to eliminate the real disease, 
toxemia. You must not imagine, therefore, that you 
have to force food into your body in an endeavor 
to increase weight because you are thin, or rest in¬ 
terminably because you are weak, or take drugs to 
suppress the fever and cough, or cut out infected 
glands or joints. All these symptoms are present 
70 


SYMPTOMS OF TUBERCULOSIS 


because they are necessary; and when their causes 
are removed they will disappear. To attempt to 
overcome symptoms without removing causes is to 
invite disaster. It is very much inclined to bring on 
complications. I do not mean by this that symptoms 
should be entirely disregarded, because they some¬ 
times need to be controlled; but do not develop an 
exaggerated idea of their importance. Especially 
is this true in the matter of weight. Many patients 
believe that if they can only gain weight they will 
be all right, whereas it is quite possible to gain 
weight and grow worse. They keep their minds 
constantly on the subject of weight; and if they lose 
a little they become greatly depressed, or if they 
gain a little they may be unduly stimulated and be¬ 
come careless in neglecting other necessary treat¬ 
ment. Let symptoms be a warning or a barometer of 
your progress, but do not worry about them. Try to 
keep a sane, balanced attitude of mind toward your 
entire condition, concentrate on fundamentals, and 
the symptoms will take care of themselves. 


71 


CHAPTER VI 

Treatment of Acute Tuberculosis 

HE treatment of all acute diseases should be 



started early. Practically all such diseases 
begin in much the same manner—with a feeling of 
general malaise (indisposition) followed by chills 
and fever. At this stage it is impossible to tell 
just what is developing; but from the standpoint of 
natural methods of treatment it is not necessary to 
know. We know that the body is starting an elim¬ 
inative crisis, and we should want to assist it in every 
way possible, as well as to avoid adding any more 
poisons to the accumulation already present. If the 
proper treatment is begun at the very onset of the 
symptoms the trouble often will be aborted and in 
all cases will be greatly lessened in severity. This 
is especially important in cases of acute tuberculosis, 
where weight and strength usually are lost rapidly 
and where results unfortunately are all too unfavor¬ 
able under orthodox methods of treatment. 

In the cases which start like typhoid fever— 
where there may be two or three weeks of general 
uneasiness, loss of weight and strength, etc., before 
much fever develops—it still will not be too late to 
start treatment when this stage has been reached. 
However, the genuine Physical Culturist takes warn¬ 
ing at the first signs of discomfort; and even if he 
does not adopt strict treatment at once he will begin 


TREATMENT OF ACUTE TUBERCULOSIS 


to seek causes for his lack of the usual “pep” and 
will modify his habits of living to some extent, such 
as modifying the diet, getting more rest and fresh 
air, etc. In this way some of the necessary meas¬ 
ures will be started before the disease has an oppor¬ 
tunity to make much progress. In cases which start 
more like pneumonia—when the fever comes on 
quite quickly—there need be no delay in starting 
treatment. If the trouble has been neglected and 
other parts of the body have become affected or 
complications have developed, these should be 
treated as described in the special sections devoted 
to that particular manifestation. As most acute 
cases occur in children, it might be well to read 
the chapter on treatment of children’s cases, also. 

In an acute case the body is very toxic and body 
cleansing is very necessary. But at the same time 
the energy must be conserved, because it is already 
depleted; and all that is left will be needed to sup¬ 
port the unusual functional activity present during 
a crisis. Systemic cleansing takes energy. Hence, a 
careful balance must be maintained between the 
cleansing and the building measures employed, in 
order that the energy may not be so depleted as to 
make healthful reaction impossible. 

As a primary measure in the conservation of en¬ 
ergy, absolute rest is very necessary. This is indi¬ 
cated by Nature, since when there is fever there is 
a desire to rest, and sometimes so great prostration 
as to make anything else well-nigh impossible. 
Therefore, as soon as the patient realizes that acute 

73 


TUBERCULOSIS 


symptoms are approaching he should go to bed im¬ 
mediately, and stay there until there has been defi¬ 
nite recuperation after all fever is gone. This is 
very important. If the patient tries to be even mod¬ 
erately active the fever will be much more persist¬ 
ent. He should not leave the bed to go to the toilet 
or for anything else. The body needs all its ener¬ 
gies to purify and protect itself and has none to 
spare for muscular activities. Rest should include 
the organs as well as the muscles of the body. This 
means that no food should be taken, because eating 
makes work for all the organs. Generally there is 
no appetite, which is proof enough that the body 
does not want food, has no need for it, and cannot 
take care of it properly. 

J Feeding should be stopped as soon as acute symp¬ 
toms develop. Plenty of water should be taken, 
however, a glass an hour or even more. This may 
be flavored with lemon or orange juice, if especially 
desired, but not sweetened. If the patient is afraid 
of the absolute fast or if there is a definite appetite 
for it, orange juice may be taken in addition to 
water, employing six or eight oranges per day. It 
usually is well to employ the fruit juice in any case 
after the first three days on water. In the milder 
cases the pulp of the fruit may be taken in addition 
to the juice. If unable to secure oranges, or if pre¬ 
ferred, unsweetened grapefruit and its juice may be 
employed. Other fruits that may be used are pine¬ 
apple and grapes. The orange and grapefruit usu¬ 
ally are best, however. They may be taken at any 
74 


TREATMENT of acute tuberculosis 


time desired, regularity not being especially neces¬ 
sary. Often a combination of orange, grapefruit 
and pineapple juices mixed will agree very well. 

The bowels must be thoroughly cleansed with a 
high enema on the first day, and if there seems to 
be much refuse in the intestines, this should be re¬ 
peated daily for three days. Otherwise the ordi¬ 
nary low enema may be employed daily for the 
duration of the fast or fruit diet. The high enema 
is taken with an ordinary fountain syringe, except 
that the long soft rubber colon tube is used instead 
of the hard rubber enema tip. This is sterilized by 
boiling, lubricated by dipping in sterile oil, and in¬ 
serted gently for 12 to 18 inches. A good plan of 
lubrication is to “feed” the tube into the rectum 
from a shallow pan containing oil, in which the tube 
lies coiled. A very little water may be allowed to 
enter while the tube is being inserted, in order to 
clear the way. Several quarts (as much as three 
or four) of plain warm water, at slightly above 
body temperature, should be used. It should be 
injected in the “knee-chest” position (on knees and 
elbows with hips elevated) whenever possible; 
otherwise the right-side-lying position, or the posi¬ 
tion on the back with the hips somewhat elevated 
on a pillow may be employed. These same positions 
are best for the ordinary enema, also, but for this 
three pints to two quarts of water generally are 
sufficient. The water should not be retained more 
than two or three minutes. With these enemas and 
75 


TUBERCULOSIS 


the water drinking the alimentary tract and to some 
extent the tissues should be cleansed. 

After the five to ten days of fasting and fruit the 
milk diet should be adopted. On the first day half 
milk and half water is used. It is very necessary to 
have raw (unpasteurized) milk. If living in a city 
requiring pasteurization the certified milk should 
be secured. In the majority of cases the following 
is the best schedule. About six ounces of the half- 
and-half should be taken slowly every two hours 
during the first day—six feedings in all. On the 
second day six ounces of whole milk should be used 
every two hours; on the third day eight ounces. 
After that the same quantity should be used per 
feeding, but the frequency to be increased to the 
following intervals: ninety minutes, sixty minutes, 
forty-five minutes, thirty minutes. When taking the 
milk every thirty minutes, six quarts will be con¬ 
sumed during the day. In the case of children the 
maximum quantity, of course, will be limited accord¬ 
ing to age. In addition to the milk the juice of two 
or more oranges may be taken each day, at any time 
desired but usually the first thing in the morning. 

The rate of increase and total quantity of milk 
used in individual cases will depend upon the con¬ 
ditions present. If fever still persists after the 
orange diet, not more than three quarts per day 
should be taken (a glass every hour) ; and for 
children half the usual quantity. In these cases of 
fever more oranges may be used—up to six, eight 
or ten per day. If the milk is not well tolerated in 
76 


TREATMENT OF ACUTE TUBERCULOSIS 

any way the quantity may be similarly limited, using 
whatever amount can be handled with comfort. 
The less milk taken the more fruit may be used. 
Other fresh fruits besides oranges may be used in 
season, except cherries and, sometimes, apples. 
Some cases may find that skim milk, buttermilk, or 
soured milk will agree better than the whole sweet 
milk, and these forms may be used entirely or in 
part. When using sour milk it generally is permis¬ 
sible to take two dates or an equal weight of raisins 
with every other glass of milk or with every glass 
if not more than three quarts are being taken dur¬ 
ing the day, though when there is fever it usually 
is best to take the milk alone. In cases where only 
a small quantity of milk can be taken but where the 
need for nourishment is imperative, one or two egg 
yolks in orange juice may be taken each day. No 
other solid foods are allowed when taking the milk 
diet. In most cases the milk and fruit can be satis¬ 
factorily adapted to the individual’s needs so that 
other additions will be unnecessary. 

It occasionally may happen that, for some reason, 
the milk diet cannot be used. Every effort should 
be made to secure the milk and use it as a strict 
diet, as it is most effective when properly employed. 
But if solid food must be utilized the following diet 
is one of the most admirable that can be employed. 
In breaking the orange diet following the fast the 
milk is employed as has been described until three 
quarts have been taken in one day. Then on the 
next day three glasses of milk with fruit should be 

77 


TUBERCULOSIS 


used for breakfast and lunch, with a light meal in 
the evening consisting of a raw vegetable salad and 
some sweet fruit, such as thoroughly ripe bananas, 
dates, figs, or raisins. I do not specify the exact 
quantities, because these will vary in individual 
cases. Masticate thoroughly and stop eating just 
before you have had “enough,” and you should have 
no trouble. This diet may be continued for many 
days; or, on the next day regular meals may be 
resumed, using such menus as are given in the next 
chapter but still limiting quantities for several days 
longer. Raw foods are particularly important and 
should be given the preference. If there is fever 
only raw fruits and green vegetables, perhaps with 
two egg yolks per day, should be taken until the 
temperature is normal, in this case breaking the 
orange diet as described in the next paragraph. 

Where milk is unobtainable it will be necessary 
to employ solid foods immediately after the fast 
and fruit diet. The following plan usually will be 
satisfactory. On the first day three meals may be 
taken, consisting of a cup of strained vegetable 
broth and five or six raw soaked prunes. The or¬ 
anges or other acid fruits may be taken as desired 
between meals. On the next day the same meals 
may be taken, with the addition of several leaves of 
lettuce. On the next day a combination salad of 
lettuce, celery, and grated carrots may be used, in¬ 
stead of lettuce only. On the fourth day regular 
meals may be resumed, the same as advised after 
breaking the fast of orange diet with milk. The 
78 



79 


A good example of a sleeping porch. One awning is shown lowered but it should be kept up most of 
the time. It may be let down to protect from rain or to shut out the sun if the patient desires to sleep 

during the day. 




















TUBERCULOSIS 


greatest care always must be observed not to over¬ 
eat. 

Fresh air night and day is extremely necessary, 
as it not only further aids in cleansing the body but 
it also gives the patient strength. The idea that 
we get strength from food alone is very erroneous. 
Good fresh air and plenty of it is always of primary 
importance in any case of tuberculosis, acute or 
chronic—and in any other disease, for that matter. 
If circumstances permit, the patient should have his 
bed placed out of doors, with just sufficient protec¬ 
tion to guard against storms. If unable to do this, 
an unusually well ventilated room should be se¬ 
lected. Fifteen hundred cubic feet of air should be 
available, which is equivalent to that supplied by a 
room fourteen feet square and, eight feet high. 
Windows should be on at least two sides of the 
room, and the more the better. They should never 
be closed except when the patient is having a bath 
or is otherwise exposed in some way in cold weather. 
In good weather it is often of value to remove the 
window sashes in order to have more open space. 
In bad weather the use of cloth window ventilators 
usually will keep out rain and snow and still permit 
the passage of some air, or foot-wide boards may 
be fitted to rest upon the lower window frame, slant¬ 
ing inward and upward, to direct upward the air 
that enters through the raised sash. In cold weather 
the room may be partially heated. Any arrange¬ 
ments that can be made to add to the patient’s sup- 
80 


TREATMENT OF ACUTE TUBERCULOSIS 

ply of fresh air will be of definite benefit. Of 
course, no one else should occupy the room. 

With complete rest, water drinking, enemas, and 
fresh air it is often possible to eliminate the fever 
within five days on the fast or oranges. If it is not 
gone within seven days but most of the other symp¬ 
toms have improved, it is well to break the orange 
diet, because tuberculosis is one disease where modi¬ 
fied feeding may be permitted even when there is 
fever. Further orange dieting may be taken later. 
It is seldom advisable to go further than three days 
on the complete fast and seven days on oranges, or 
a total of ten days at the start, owing to the rapid 
loss of weight and strength associated with the dis¬ 
ease; and in most cases a total of five days on the 
fast and orange diet will be sufficient. 

If fever goes above 103 degrees, a cool sponge 
bath may be given to reduce it. A tepid sponge 
bath should be given daily in any case; and strict 
cleanliness of the clothing and bed clothing should 
be observed. The patient should wear as little 
clothing as possible; nothing at all when warmth 
can be maintained. In giving baths in bed it is best 
to bathe one part and dry that part before proceed¬ 
ing to the next part, keeping the body covered except 
for the part being bathed. Bathing should be fairly 
rapid so as not to expose the patient for any great 
length of time, though, of course, in warm weather 
it is not necessary to use this care. The tempera¬ 
ture of the bath should be gradually reduced until 
81 


TUBERCULOSIS 


it can be taken fully told, or at about 60 degrees 
and enjoyed and reacted from. 

If there is much pain in the chest or abdomen a 
cold pack to these regions may be applied daily for 
two hours. This consists of several thicknesses of 
muslin or linen cloth wide enough to cover the chest 
or abdomen and long enough to go completely 
around the body. It is wrung out of cold water, 
applied quickly and snugly, and completely covered 
with a heavy dry woolen cloth, such as a p’ece of 
old blanket, of two or more thicknesses. The 
woolen cloth should be somewhat wider than the 
under cloth, so as completely to cover it and prevent 
all air from contact with the wet pack. This in turn 
is covered with mackintosh, if available, or any other 
impervious material. When properly applied the 
pack soon becomes warm, and sweating should be 
induced within two hours. If there is not much 
fever, or if the patient feels chilly, or if there is 
actual pleurisy, a hot pack may be applied, using 
hot water bottles to maintain warmth. 

Air baths, dry friction baths, and nude sun Laths 
also should be used. The air bath may be given at 
any time and continued as long as possible without 
chilling. In the winter time it may be impossible to 
give these unless able to heat the room quickly, be¬ 
cause the patient’s supply of fresh air should not 
be cut off for long at a time. The air bath is simply 
exposure of the nude body to the air. It is soothing 
yet tonic, and gives the body an opportunity to ab¬ 
sorb more oxygen. An assistant can administer dry 
82 


TREATMENT OF ACUTE TUBERCULOSIS 


friction with the bare hands at the same time. The 
friction should not be continued longer than ten 
minutes, however, and may be omitted if the pa¬ 
tient is very weak. It should be omitted if the 
patient has much fever. 

Sun baths are employed whenever circumstances 
permit. For results, it is necessary that the unob¬ 
structed rays of the sun reach the nude body. They 
are best taken out of doors, but may be taken inside 
if the sun shines freely through an open window. 
The upper sash may be lowered; the bottom sash, 
then being closed, will protect from draft and may 
be covered to give privacy if necessary. The room 
should be heated for the sun bath in cold weather. 
Exposures must be short at first and increased grad¬ 
ually, especially in summer, beginning with five to 
ten minutes, depending on the condition of the pa¬ 
tient and the heat of the sun. The hotter the sun 
and the weaker the patient the shorter the initial 
application. The rate of increase practically always 
is the same, two minutes per day—one minute for 
each side (front and back), as both sides, of course, 
should be exposed. The maximum length of appli¬ 
cation is four or five hours. 

When there is fever, however, it is necessary to 
limit the applications considerably. In such a case 
the feet only are exposed the first day, then the 
feet and legs up to the knees, then up to the hips. 
After several days the abdomen may be included, 
and in a few days more the upper body and back. 
The time for the initial application and the rate of 
83 


TUBERCULOSIS 


increase should be adhered to for each part until 
the whole body is being exposed, when it may be 
considered as a unit. The head should be covered 
until the general condition is considerably improved, 
and some cases may have to follow this plan al¬ 
ways. At the conclusion of the bath a brief ap¬ 
plication of cold water should be made to the parts 
which have been exposed. The maximum applica¬ 
tion, until all fever is gone, should be limited to 
thirty minutes. If possible, the bath should be 
taken at a time of the day when there is no fever. 
If the fever is over ioi degrees the sun bath must 
be omitted. 

Whenever possible to secure ultra-violet radia¬ 
tions from the special lamps designed for their ap¬ 
plication, these are to be preferred to the natural 
sunlight as long as there is fever. Many people 
have these lamps in their homes, there being made 
for home use smaller lamps than are devised for 
physicians’ offices, hospitals and sanitarium use. The 
applications must be begun carefully and increased 
gradually, the same as for the sun baths, except that 
the initial exposure usually is two or three minutes 
with the lamp at a distance of 35 inches from the 
body. Much depends upon the individual’s reac¬ 
tion. Particularly for this reason it is best to have 
the advice of a doctor when using this treatment. 
These radiations are of the utmost value when un¬ 
able to secure natural sun baths for any reason. 
One or the other, however, is a very necessary part 
^of the treatment. 


84 


TREATMENT OF ACUTE TUBERCULOSIS 

The patient should sleep as much as possible, as 
the body works best toward overcoming debility and 
disease during sleep when all conscious interferences 
are removed. At this time all the energies of the 
body can be devoted to remedying anything which 
may be wrong within it, and at such times the most 
rapid progress is made. There may be less in¬ 
clination to sleep when the patient is resting con¬ 
stantly, but the practise of mental and physical re¬ 
laxation will help much to induce it. If sleep itself 
does not come for any certain increased number of 
hours, the full relaxation will be almost as good. 
In any case, useless expenditure of energy in waste 
motions, unnecessary activity, visiting, and worry 
and other destructive emotions should be avoided. 

Control of the thoughts is quite important. 
Often the diagnosis of acute tuberculosis is sufficient 
to frighten many people almost to death, and many 
times the doctor makes no attempt to encourage the 
patient. The importance of adhering to strict 
treatment can be emphasized without frightening 
the patient. Relatives and friends also should be 
as cheerful and optimistic as possible or give way to 
those who can cheer, at least not depress the pa¬ 
tient. Any supposed friends who come in and talk 
about everyone they know who is sick or has just 
died, should be gently but firmly shown the door and 
denied further admittance. The patient himself 
should realize that recovery depends upon being con¬ 
fident and persistent in helping the body cure itself. 

85 


TUBERCULOSIS 


He should haye no doubt whatever as to ultimate 
recovery. Autosuggestion is also of value. 

In all cases where fever persists after the first 
fast and orange diet, an additional fruit diet of 
three days should be taken as often as the weight 
and strength will permit until the fever is com¬ 
pletely eliminated at all hours of the day. Even if 
fever does disappear after the first fast and orange 
diet it is well to take the fruit for a day or two 
every month until recovery is established. Over¬ 
feeding never did anybody any good. The impor¬ 
tant thing is to utilize completely all the food taken 
so that there is no excess to lie in the intestines, 
ferment and putrefy, and add to the toxins already 
in the body. The repeated orange diets are very 
effective in improving the digestive and assimilative 
ability, as well as in detoxifying the body. 

The other measures which have been described for 
purifying and strengthening the body must be con¬ 
tinued as long as necessary. It is well to continue 
rest in bed for at least a week after fever is gone, 
and most cases will require more than this time 
for recuperation, because of the rapid destruction 
of tissue in acute cases of tuberculosis. It is often 
advisable to remain in bed until most of the symp¬ 
toms have subsided and weight has been restored 
nearly to normal. The patient may then get up 
gradually, first sitting up a half hour at a time, 
gradually lengthening this to two hours, then getting 
up for meals, then walking. Walking should be 
started with five-minute periods and increased three 
86 


TREATMENT OF ACUTE TUBERCULOSIS 

to five minutes per week according to the ability. 
At this stage the procedure is practically the same 
as in chronic cases. 

If advantage is taken of the simple forces of na¬ 
ture, such as air, sunlight, water, and plain foods; 
if the body is given an opportunity to utilize these 
forces through rest, relaxation, sleep and, later, 
graduated exercise; and if proper control of the 
body is maintained by the mind at all times, there is 
no reason why recovery should not be certain in 
the great majority of cases. 


87 


CHAPTER VII 


Treatment of Chronic Pulmonary 


Tuberculosis 


HE picture of the typical case of chronic 



pulmonary tuberculosis showing emaciation, 
weakness, hectic flush and cough indicates to anyone 
that the primary need here is to build more vitality, 
to increase the energy, and to promote resistance. 
The ordinary person would say that more vigor is 
needed to fight the disease. This is not strictly the 
case, as the disease does not need to be fought but 
to have the causes removed. Yet there certainly is 
a need for more vital power. What are the sources 
of this power? Air, sunlight, water, food and sleep. 
Then when there has been a small surplus of vital 
power accumulated it generally is necessary to create 
a demand for more through exercise. 

However, one can build only when there is a 
solid foundation upon which to construct the edifice. 
In order to build health it is necessary to have the 
solid basis of clean tissues. But to cleanse the body 
takes energy, and the patient may have little or none 
to spare. In cases of chronic tuberculosis it usually 
is not possible to cleanse the body thoroughly be¬ 
fore employing the building measures. A compro¬ 
mise must be effected between the cleansing meth¬ 
ods which take energy and the building measures 
which give vitality. Fasting is, of course, the pri- 


88 


CHRONIC PULMONARY TUBERCULOSIS 

mary method of cleansing; but a long fast is not 
advisable in these cases. Some persons have taken 
long fasts with good results; but I do not advise 
them. Too much weight is likely to be lost, and 
this may be difficult to regain. Not that the weight 
itself is so important, but there is such a thing as 
reducing the energy and reserve force to a point 
where this becomes insufficient to react or where the 
reaction becomes very slow. Moreover, certain 
nourishing elements, such as the mineral salts and 
vitamins, are very necessary, and few persons who 
are in such a condition as to develop tuberculosis 
have sufficient of these in the body to last them dur¬ 
ing a long fast. An extra supply of these elements 
is required, rather than a lessened one. The best 
plan, therefore, is to do a little cleansing while rest¬ 
ing to save energy, then a little building, then a little 
more cleansing, then more building. In this way the 
body is nursed along to the point where it can over¬ 
come the morbid processes. 

Fortunately it is possible also to build while 
cleansing. Air, for instance, not only cleanses but 
furnishes necessary building elements. The same is 
true of water. Sunlight is cleansing through its 
antiseptic action and its stimulating effect on the 
skin, but also building through its effect on the chem¬ 
ical composition of the blood and the energy con¬ 
tained in its rays. By a judicious use of all the 
forces of Nature the special needs of the body dur¬ 
ing tuberculosis can be met. To sum up, we should 
assist the body in every possible way, and interfere 
89 


TUBERCULOSIS 


with it not at all. To this end we use rest, diet, 
air, sunlight, water, exercise, and proper control and 
use of the mental processes. 

REST 

Our medical contemporaries will tell you that 
rest is 50 per cent of the treatment of tuberculosis, 
and some rank it even higher. Some of the enthu¬ 
siastic ones will claim that it is impossible to get too 
much rest. But the body never was intended to 
stagnate. While rest may be 50 per cent of the 
treatment at certain stages it is not always so, and 
indefinite rest is certainly not to be recommended. 
However, without doubt a certain amount is of the 
greatest assistance. A penny saved is a penny 
earned; and if one cannot earn or build energy he 
at least can conserve what he has. This is the pur¬ 
pose of rest. Rest is employed during the initial 
period of the cleansing, which makes subsequent 
building possible. It also is used afterward to bal¬ 
ance exercise and to guard against any possible 
shortage of energy which might occur as a result of 
too much enthusiasm on the part of a patient just 
beginning to feel like himself again. 

The exact amount of rest required will depend on 
the stage of the disease and the general condition 
of the patient. For instance, in incipient cases where 
the general health is still good and there is little 
or no fever it may not be necessary to go to bed, 
but merely to get plenty of night sleep and, perhaps, 
an extra nap during the afternoons. In a moder- 
90 


CHRONIC PULMONARY TUBERCULOSIS 


ately advanced case it usually is well to go to bed 
for a time; but one need not be so careful to avoid 
all exertion as would be the case in an acute con¬ 
dition. In an advanced case, with well marked fe¬ 
ver, complete rest in bed will be required until sev¬ 
eral weeks after all fever is gone. The general 
condition of the patient may not always coincide with 
the stage of the disease. Some incipient cases may 
be quite reduced in vitality and be highly toxic. 
These should rest, as should a more advanced case. 
In advanced cases which still have considerable en¬ 
ergy it may be possible to get along with less rest; 
but usually it is well to treat them according to the 
stage of the disease. In any case, even the lightest, 
it generally is advisable to go to bed for a couple 
of weeks, in order to get a good start. After this, 
the degree of activity may be determined by the 
stage of the disease, the effects of the degree of ac¬ 
tivity attempted, the general condition, and the rate 
at which the patient is responding to treatment. It 
seldom is necessary to remain in bed more than six 
or eight weeks, except in the most advanced cases. 
Remaining in bed for a year and, sometimes for two 
or three years is not to be recommended. If such 
extended rest seems to be required there is some¬ 
thing wrong with the treatment. Under the right 
kind of treatment the fever will be eliminated within 
from one to six weeks, and two or three weeks after 
this will be sufficient time to remain in bed. Of 
course, one does not get up suddenly and resume 


TUBERCULOSIS 

all his old activities. This must be done only very 
gradually. 

The usual plan of resuming activity will be about 
as follows: On the first day it is deemed advisable, 
the patient may be allowed to sit up in bed or in a 
chair for half an hour during the morning and for 
the same time in the afternoon. The successive fol¬ 
lowing days the time may be increased to forty-five 
minutes, then an hour, then ninety minutes, then two 
hours. Or such increase may be made every two 
or three days. After this the patient may be allowed 
to get up for meals, which, however, should still be 
served in his room for several days. If there are 
no stairs to climb he can then go to the dining room 
for meals; or if he is taking milk or if there are 
stairs to climb he can practise walking about the 
room for a few minutes at a time, resting between 
times and not being up more than forty-five minutes 
at one period. About ten days from the time he 
first gets out of bed he should be able to go down 
and slowly up stairs and be up about two hours per 
day. This can be increased gradually to four hours 
a day, two in the morning and two in the afternoon. 
At the end of the third week he can start exercise, 
as will be described later on in this chapter. Even 
after the point is reached where considerable exer¬ 
cise can be taken the patient should be in bed ten 
hours during the night and four hours during the 
day. This plan should be continued until a fully 
normal condition has been restored. I might say, 
however, that when this time is approaching the pa- 
92 


CHRONIC PULMONARY TUBERCULOSIS 


tient need not rest in bed the full four hours during 
the day, but can spend three of these hours in an 
easy chair or recliner. This plan is not to be con¬ 
sidered arbitrary, but merely as a model. The rate 
at which the patient can advance from rest in bed 
to exercise will always depend upon how long he 
has been in bed and how he reacts to the increased 
activity. “Make haste slowly” is a good motto at 
this time. 

It is very important that the patient rest while 
he is resting. This may seem an unnecessary admo¬ 
nition; but it is surprising to find how few people 
know how to rest. Rest means relaxation, if not 
sleep. The more sleep the better; but when this 
cannot be induced, thorough relaxation will answer 
very well. In order to be sure that he is perfectly 
at ease the patient should go over the entire body 
mentally to see that every muscle is completely re¬ 
laxed. He should say to himself “Let go!” It 
sometimes helps to raise a limb and then let it drop 
perfectly limp, repeating with all four extremities. 
Taking a deep breath and letting it out quickly is 
helpful, also. Every voluntary effort should be sus¬ 
pended, except as stated. After the body is well 
relaxed the mind should be given attention, making 
it as nearly as possible a blank. Of course, such 
complete relaxation is not necessary during the- en¬ 
tire day when a person is in bed all the time; but at 
no time should there be unnecessary tension. It 
will be especially necessary to give particular atten- 

93 


TUBERCULOSIS 


tion to relaxation while resting when the patient is 
up a good part of the day. 

I have already said something of the importance 
of sleep in the chapter preceding this one, but I wish 
to add a few points here. It has been said that sleep 
is “Nature’s sweet restorer.” If any one needs re¬ 
storing it is the tuberculous patient. Sleep is the 
silence during which Nature does her best work. 
When awake, even while resting, the conscious mind 
is busy with many things; this is bound to have some 
effect on the body. All too often it is busy with the 
wrong kind of thoughts, and this definitely interferes 
with progress. Even reasonable thinking takes 
some energy and distracts that part of the mind 
which governs the functions of the body. On the 
other hand, while asleep all conscious activities are 
suspended, the guiding intelligence within has full 
sway (except perhaps for a few bad impressions 
made during the day), and it then can do its best 
work. Relaxation is more perfect during sleep, 
and this means that the circulation is more free, 
there is less interference with nerve action, and 
every function is being performed more perfectly. 
It is chiefly during sleep that energy is recuperated 
and stored up. Hence, one can readily see that the 
more one can sleep the sooner will he get well. 

Let no one think, however, that he should take 
medicines to induce sleep if he should find it diffi¬ 
cult to slumber naturally. By no means should sleep 
be induced by a hypnotic or a narcotic. Such sleep 
has little value, for it is brought about through in- 

94 


CHRONIC PULMONARY TUBERCULOSIS 

terfering with nerve action. One is but little if 
any further along toward recovery after such sleep 
is ended. Moreover, the after-effect is increased 
irritation and tension. While it might be permissi¬ 
ble temporarily to use some of the milder hypnotics 
in extreme cases where sleep is prevented by severe 
pain, when other proper measures are being used at 
the same time, still I can not recommend the prac¬ 
tise. The less of this done the better for any pa¬ 
tient. The strictly natural methods for relieving 
pain and inducing sleep will be quite satisfactory. 
Heat practically always relieves pain; and sleep may 
be induced by relaxation of mind and body, slow 
deep breathing, the neutral immersion bath, hot 
spinal compresses, gentle spinal pressure, and auto¬ 
suggestion. The latter will be covered later on in 
this chapter. Peace of mind and comfort of body 
are important factors in producing sleep; and if the 
patient is being treated rightly his progress will give 
him peace and Nature will give him comfort. In¬ 
ternal discomfort is present only when it is neces¬ 
sary; and if one works with instead of against the 
body there will be no need for it. In most cases it 
should be possible for the patient to sleep nine or 
ten hours during the night and one hour during the 
day. 

Another form of rest which is of the highest im¬ 
portance is sexual rest. The body needs all its 
energy in order to restore a normal condition, and 
there is none left to spare for physical sexual expres¬ 
sion. The patient must decide to forget all about 
95 


TUBERCULOSIS 


such expression until complete recovery has been 
brought about. The mind may be kept away from 
sexual matters by keeping it busy with the various 
duties of the day and with constructive thoughts for 
the benefit of oneself and others. Of course, the 
patient will sleep alone. 


DIET 

The subject of diet for tuberculosis means to 
many people, and even to many practitioners of the 
healing art, simply eating as much as possible, in¬ 
cluding plenty of milk and eggs. “Plenty of good 
wholesome food” is the usual prescription. It is 
self-evident to any thinking person that this can lead 
only to trouble, for if the patient has been losing 
weight while eating his usual and often more than his 
usual quantity of food, it must be because his diges¬ 
tive and assimilative organs are not working as they 
should. To call on them for more work will exhaust 
them further. Eating more than the body needs or 
can handle always wastes energy. What is the use 
of resting in bed to save energy and then wasting 
it by overeating? While resting in bed one needs 
less food than when active, for less tissue is being 
destroyed and less energy is being used. It will 
simplify matters greatly if the patient remembers 
that strength comes as much from air, sunlight, 
water and sleep as it does from food. The old idea 
that one must eat to keep up his strength has been 
exploded long ago; but like many such ideas it still 
persists in the minds of many people. Another 
96 


CHRONIC PULMONARY TUBERCULOSIS 

thing to remember is that it is unnecessary to feed 
especially for weight gaining. When the body has 
been cleansed and the energy increased the weight 
will take care of itself. The addition of weight does 
not indicate, necessarily, that the condition is being 
improved. If the weight is low it is because it needs 
to be low in order that the body may not have to 
spend a lot of time and energy in building tissue 
and removing its waste products; or because there 
are physiological abnormalities that must be over¬ 
come before sufficient nutriment can be digested, ab¬ 
sorbed and assimilated to increase the weight. 
Feed for health, and the weight will be adequate. 

In feeding for health the important thing is to 
use moderate amounts of highly vital foods, with 
short periods of abstinence for internal rest and 
cleansing. Some may wonder why internal rest is 
necessary. They know that they must rest their 
muscles; but they think their organs will keep on 
working indefinitely. They feel that internally they 
have solved the problem of perpetual motion—until 
one day they wake up to find something, perhaps 
everything, broken down. Even the heart must 
have its rest between beats. So is it necessary to 
give the digestive and assimilative organs a rest 
from time to time in order that they may the more 
perfectly handle the food during their periods of 
activity. Regular periods of abstinence act as a 
tonic and greatly improve the digestive and assimila¬ 
tive abilities. They also allow for extra cleaning in 
case the patient has not been sufficiently careful with 
97 


TUBERCULOSIS 


his diet. In a case of tuberculosis extra cleansing is 
necessary, anyhow. So going practically without 
food for several days every month is not going to 
weaken the patient or keep his weight down, but 
actually will strengthen him and stimulate the pro¬ 
duction not only of weight but of normal organic 
function. 

By vital foods I refer to those which contain the 
most “life.” These are the ones which have a 
goodly proportion of the all-important mineral ele¬ 
ments and vitamins. A certain amount of protein, 
carbohydrates and fat, of course, is necessary; but 
those sources of these elements which also supply 
the minerals and vitamins will be found the most 
vital and effective. Vital foods are those which are 
in their natural state, that is, raw and unprocessed. 
Fruits, vegetables, milk and milk products, whole 
grains, nuts, and eggs are the important foods to 
use. Owing to its similarity to blood, to its goodly 
supply of vital elements, to its balance of elements, 
and to its ease of digestion, milk is the food par 
excellence; but it must be good raw milk. 

The exact dietetic regimen which will be required 
in any case will depend upon the stage of the disease, 
the general condition of the patient, his idiosyncra¬ 
sies, his mental attitude, and his changing condition 
from day to day. However, there is a general plan 
which practically always applies, and anyone with 
a little intelligence can adapt it to his needs. I 
shall give the usual plan and note variations which 
may be required. 


98 


CHRONIC PULMONARY TUBERCULOSIS 


The first thing to do is to take a fruit diet. This 
may consist of oranges alone or of oranges, grape¬ 
fruit, pineapples, and grapes. In the more severe 
cases the juice alone is employed. But in the lighter 
cases the pulp also may be used; and berries, peaches, 
pears, plums, and apricots may be eaten in season. 
All the fruit must be taken raw and unsweetened. 
Usually as much as desired may be allowed, as the 
appetite is not often very keen. The fruit may be 
taken as three meals, or in smaller quantities at 
more frequent intervals. Many cases take an orange 
every hour for ten or twelve hours each day of the 
fruit diet. Reason must be used, however, and 
eating to repletion must be avoided. From two to 
four quarts of water should be taken each day, de¬ 
pending upon the amount of fruit taken. The water 
should be the purest obtainable, but this does not 
mean distilled water. Some hot and some cold 
water may be used, the proportions depending upon 
the desires and the reactions of the patient. In cold 
weather or if the patient is reduced in weight and 
strength, hot water often will be preferred. It 
should never be taken so hot that there is danger 
of burning, nor so cold that a chilling effect is felt. 
Ice-water or other iced beverages should never be 
used. Daily enemas are necessary while on the 
fruit diet, unless there is a satisfactory daily evacua¬ 
tion without it. 

The length of this fruit diet varies from three to 
seven days, continuing .up to seven days, whenever 
the patient can endure it without undue loss of 


TUBERCULOSIS 


weight and strength. When resting in bed there are 
few who will not be able to take the diet for a week. 
The fruit diet is considerably easier upon most pa¬ 
tients than is the absolute fast. The latter is not 
particularly needed in chronic cases. The fruit re¬ 
quires little digestion, and does not interfere with 
cleansing. On the other hand it aids in cleansing 
the digestive tract, and gives just enough energy 
material to avoid depression. Also, the minerals 
and vitamins supplied by the fruit are of the great¬ 
est assistance in normalizing the body chemistry and 
promoting metabolism. 

An additional two or three days on fruit may 
be observed every month, though if fever persists 
after the first fruit diet it may be well to take up to 
five days on the fruit as soon as the weight and 
strength will permit, using the regular fruit for 
shorter periods thereafter. It is important that the 
fever be eliminated as soon as possible, because when 
this has been done at least the most important part 
of the needed cleansing has been accomplished. 
These fruit diets are especially helpful in bringing 
about this desirable condition, and this is the reason 
for repeating them as frequently as the condition 
will permit until all fever is gone. 

Thereafter fruit for a few days a month or, pos¬ 
sibly every six weeks will give the needed rest to 
the internal machinery. 

After the fruit diet the milk and fruit diet should 
be adopted in most cases. The amount of milk 
taken will depend upon the length of the fruit diet. 

100 


CHRONIC PULMONARY TUBERCULOSIS 

In most cases it will be possible to take a glass of 
milk (8 ounces) every two hours during the first 
day, making six glasses in all. On the next day, 
double this quantity should be taken, or a glass every 
hour. Four glasses may be added each day until 
five or six quarts are being consumed. Some cases 
may have to increase more slowly, adding only two 
glasses per day. This is more likely to be neces¬ 
sary if the fruit diet is continued beyond five days, 
or if any difficulty is experienced in handling the milk. 
If fever is present after the fruit diet the quantity 
of milk should be limited to three quarts per day un¬ 
til the temperature is normal. 

Ordinarily from two to six oranges per day are 
taken with the milk, but if only three quarts of milk 
are consumed a greater variety and quantity of fruit 
may be used, but only the acid and subacid varieties. 
Dates, figs, raisins, bananas and such sweet fruits 
should not be employed, except in very special cases. 
If only able to take a small quantity of milk, and 
constipation is severe, some figs or non-seeded 
raisins may be used. If diarrhea occurs, two, three 
or four dates may be taken with every other glass 
of milk. Also, in this case, the quantity of milk is 
limited to four quarts per day, or even less. If the 
proper kind of milk is secured—fresh and unpas¬ 
teurized—there should be no trouble. Holstein 
milk is usually best, but a mixed milk may be per¬ 
fectly satisfactory. Jersey milk is not satisfactory, 
though some cases can handle it if about one-third 
of the cream is removed. Usually more fruit should 
101 


TUBERCULOSIS 


be used if Jersey milk is used. Various cases may 
find that skim milk, buttermilk, or soured milk may 
agree better. See discussion of the milk diet in the 
chapter on treatment of acute cases. 

Enemas may be necessary while on milk. How¬ 
ever, it usually is well to reduce the quantity and 
temperature of the water used in the enemas until 
just enough cool water is employed to produce a 
movement. This helps to restore normal action 
more quickly. It is not necessary to drink water 
while on milk, but if there is a distinct thirst for it, 
it can be taken. 

If the patient seems unable to handle more than 
a small quantity of milk or if an adequate amount 
of good milk cannot be obtained, the next best plan 
is milk during the morning and a meal at night. 
The milk is started the same as for a full diet after 
the days on fruit. When three quarts per day have 
been taken for two days, two quarts can be taken 
during the morning of the next day, finishing not 
later than one o’clock. Nothing should be taken 
in the afternoon except, possibly, some water, or 
an orange or two an hour after taking the last glass 
of milk. The evening meal will be the same as when 
taking solid foods. The quantity of milk used dur¬ 
ing the morning may be increased one glass per day 
up to three quarts, but no more is ever taken than 
can be handled with comfort. Two oranges in the 
morning before starting the milk should be suffi¬ 
cient fruit except what is desired with the evening 
meal. 


102 


CHRONIC PULMONARY TUBERCULOSIS 


A variation of this plan is two meals of milk 
and fruit and the evening meal of solid food. Two 
or three glasses of milk may be taken per meal 
with fruit as desired, chiefly acid and subacid fruits, 
but also some sweet fruit. Or, if it seems to agree 
better, the quantity of milk may be limited to two 
glasses per meal and a pint taken between the two 
milk meals. On this plan six glasses of milk during 
the morning usually are enough, though some can 
take eight. Various combinations of fruit may be 
tried, using those that agree the best. The com¬ 
bination of milk and fruit is always good, but some 
may find that certain combinations agree better than 
others. If buttermilk or sour milk is employed at 
some meal only sweet fruit should be used with it. 

But let us suppose that milk is entirely unobtain¬ 
able or that no adaptation of the milk diet will agree 
with the patient. This very seldom occurs, but 
sometimes is met with. In such cases the next best 
plan is to use raw foods. Such a diet consists of 
fruits, vegetables and nuts with, perhaps, some 
whole grain products. Eating must be resumed very 
gradually after the fruit diet, using nothing but 
fresh fruits and green vegetables for two or three 
days. Three meals may be taken, making one of 
subacid and acid fruits and the others of fruits and 
vegetables. All fruits agree with all fresh green 
vegetables, and most cases can employ any com¬ 
binations of these. However, simplicity always is 
important, and it is well not to use more than three 
or four different things at a meal. Also, the quan- 
103 


TUBERCULOSIS 


tides should be small for the first few days. After 
this period the sweet fruits and starchy vegetables 
may be added, and moderate amounts of nuts and 
whole grain products. If milk is obtainable, from 
two to four glasses per day may be used, which will 
require that less nuts be taken. The whole grain 
products may be partly cooked. Plenty of water 
should be taken between meals. Thorough mastica¬ 
tion must be practised, and care observed never to 
overeat. 

For those who will not confine themselves entirely 
to raw foods a mixed diet of strictly natural foods 
may be used, though, of course, one cannot expect 
as good results as from milk or raw foods. Eating 
should be started after the fruit diet the same as sug¬ 
gested above. But after the few days on fresh 
fruits and green vegetables, other fruits and vege¬ 
tables, nuts, whole grain cereals, milk and milk prod¬ 
ucts, and eggs may be added. Raw foods predomi¬ 
nate in the diet, though some cooked ones may be 
taken. Garlic and onions are especially good. Some 
garlic always should be used, even though it does 
not impart a pleasant odor to the breath. These 
two vegetables have quite an antiseptic effect. Some 
claim that garlic is almost a cure in itself for tuber¬ 
culosis, though I cannot endorse it this strongly. 

Special care will have to be observed not to mix 
too many things together; and the combination of 
acid fruit with starch of any kind should always be 
avoided. Other combinations that should be 
avoided, for one reason or another, are acid fruit 
104 


CHRONIC PULMONARY TUBERCULOSIS 


with refined sugar, cereal and sugar, nuts and eggs,, 
and in some cases sweet milk and green vegetables. 
Buttermilk or clabbered milk always agrees well 
with the green vegetables. Meat should be avoided 
in most cases; and when employed it should be used 
in moderation and confined to fish, chicken, oysters, 
and broiled beefsteak, and always taken with green 
vegetables only, preferably uncooked. Flesh foods 
should not be combined with milk, eggs, cheese or 
nuts. 

No matter which diet is used the fruit diets should 
be repeated, as has been previously described. When 
using solid foods during fever they should be lim¬ 
ited to raw fruits and vegetables, with two egg yolks 
or a glass of buttermilk per day. It sometimes 
happens that the patient will tire of the full milk 
diet, even though it agrees well. In such a case one 
of the combination diets or the raw food diet may 
be employed for a time for variety. After three 
or four weeks, however, there should be two or 
three days of fruit diet and the milk diet resumed. 
It is very seldom that a patient will tire of the com¬ 
bination diets. This may occur when solid foods are 
used, but in this case the trouble is best corrected by 
taking fruit alone for a few days. 

The mental attitude toward food is important, 
no matter what particular diet is employed. Most 
people regulate their diet according to what they 
like and dislike, regardless of the real values of the 
foods employed. One’s likes and dislikes usually are 
a result of habit, and a little effort soon will de- 
105 


TUBERCULOSIS 


velop a taste for foods which are truly beneficial. 
After being away from the harmful ones for a time 
the taste for them will be lost largely or entirely, so 
that little difficulty will be experienced in avoiding 
them. Especially in a case of tuberculosis the pa¬ 
tient should remember it is far more important to 
eat to live than to live to eat. When resting and 
there is little to do, especially in the lighter cases 
where the patient does not feel so badly, there is 
a strong tendency for the mind to dwell upon eating 
and a false appetite may be developed or eating will 
be indulged in without appetite. This should be 
guarded against. 

One always should eat in a cheerful and happy 
frame of mind. If worried or emotionally disturbed 
to any extent in any way it would be better to skip 
a meal or more until the balance has been regained. 
If possible to eat with others who are in the proper 
frame of mind, and especially those who realize the 
importance of cheer and pleasant thoughts, it would 
be of the greatest assistance. Eat what your reason 
and special study say are best suited to you; and 
with these as a foundation think of the food as be¬ 
ing life, and see that life being transformed into 
your life and manifesting as tissue and energy and 
function as may be needed. Eat with confidence 
that the food is going to do you good, and with 
thanksgiving that you have it to eat and are able to 
handle it. If at any time you should not be able 
to get the food which you know you require, eat 
the best foods available and do not worry. The 
106 


CHRONIC PULMONARY TUBERCULOSIS 


worry will do you more harm than occasional use 
of doubtful foods. Do not become neurasthenic 
on the subject of foods. Diet is very important, 
but do not allow it to obscure everything and be¬ 
come an obsession. Do not eat and then sit around 
waiting for something to happen. Eat as I have 
directed, chew the food well (even milk), eat in 
moderation and with simplicity, and then, having 
eaten, forget about that meal. 


RAW FOOD MENUS 


breakfast: lunch: 


dinner: 


Monday 

Oranges 

Pineapple 


Apples 

Dates 

Milk 


Tuesday 

Flaked wheat Lettuce and tomato 
Raisins Buttermilk 

Milk Dates 


W ednesday 

Grapefruit Spinach 

Dates Carrots 

Walnuts Prunes (Soaked) 


Thursday 

Oranges Pecans 

Bananas Apple 

Whipped cream Celery 


Friday 
Rolled oats 
Figs 
Milk 


2 egg yolks in 
orange juice 
Celery 
Dates 


Lettuce and carrot salad 

Almonds 

Radishes 

Figs 

Hot water with cream and 
honey 

Celery and onions 
Ripe olives 
Apple 

Banana and cocoanut 

Combination salad with 
garlic 

Cottage cheese or pignolia 
nuts 
Raisins 
Cereal coffee 

Cabbage salad 
Ripe olives 
Chopped beets 
Prune-whip 

Lettuce and cucumber 
Radishes 
Walnuts 
Grated turnip 
Hot water with cream and 
honey 


107 


TUBERCULOSIS 


Saturday 

Peaches 

Pears 

Cocoanut 

Sunday 

Bananas 

Apricots 


Combination salad 
with garlic 
Buttermilk 
Dates 


Celery and onions 

Pecans 

Carrots 

Raisins 


Spinach 

Beets 

Prunes (soaked) 


Lettuce and tomato salad 

Cauliflower 

Walnuts 

Figs 

Gelatine with cream 
Vegex or Savita “tea.” 


MIXED DIET MENUS 


breakfast: 


lunch: 


dinner: 


Monday 

Oranges 

Raisins 

Milk 


Combination salad Tomato soup 
Buttermilk with Green beans 

cream Lettuce and onion salad 

Whole wheat bread and 
butter 
Prunes 


Tuesday 

Shredded Wheat 2 egg yolks in 
Honey orange juice 

Milk and cream Celery 
Dates 


Fresh corn 

Cold slaw (no vinegar) 
Ripe olives 
Rye krisp and butter 
Cereal coffee 


IV e dues day 

Steel cut oatmeal Vegetable soup Fresh fish 

(cooked five Whole wheat zwei- Lettuce with chopped onion 
minutes') bach and butter Spinach 

Raises Gelatine Peaches 

Milk and cream 


Thursday 
Whole Grain 
Wheat 
Honey 
Milk 


Apple, celery and Baked potato 
nut salad Kale 

Grated carrots Hearts of lettuce 
Prunes with Cottage cheese 

whipped cream Cereal coffee or Vegex 


Friday 

Baked apple 
with cream 
Shredded Wheat 
Honey 
Milk 


Combination salad Potato soup 

Whole wheat bread Cauliflower 

and butter Cold slaw (no vinegar) 

Banana and cocoa- Ripe Olives 

nut Whole wheat raisin bread 

with honey 


108 


CHRONIC PULMONARY TUBERCULOSIS 


Saturday 


2 poached eggs 


Peaches 

Pears 

Walnuts 


Sauerkraut (raw) Green beans 


Celery and onions 

Whole wheat zweibach and 


butter 

Fig pudding 


Sunday 


Grapes 


Vegetable soup 
Corn muffins and 


Roast chicken 
Spinach 

Lettuce, cabbage and garlic 
salad 
Apricots 


Dates 

Milk 


butter 

Prunes 


AIR 


Air well might be included in the subject of diet, 
for it distinctly is a food. But the function of 
breathing, in which air is utilized, is more than a 
process of digestion and assimilation, being also a 
process of elimination. Air, therefore, is doubly 
important; and the proper kind must be secured 
day and night in cases of tuberculosis. The proper 
kind of air has been the subject of great controversy. 
The only point upon which all are agreed is purity, 
and that really is the fundamental one. If one 
secures pure air and plenty of it there need be no 
energy wasted in worrying about whether it is moist 
or dry, hot or cold, rarefied or otherwise. For in¬ 
stance cool air generally is considered the best; but 
I know of several cases which were greatly bene¬ 
fited by the hot dry air of the desert. Of course, 
these factors do have some effect, and patients may 
do better in one climate than another and different 
patients seem to do better in different climates. But 
when the right treatment in general is being used 
I am sure that there are few who cannot get well 


109 





110 


Resting and sleeping out of doors in cold weather. When well wrapped up the patients can endure a 
very low temperature. If it is very cold, however, the hands should be kept under the covers or should 

be protected with mittens. 













CHRONIC PULMONARY TUBERCULOSIS 

in any climate so long as plenty of pure fresh air is 
secured. 

By pure air I mean air which is not contaminated 
with dust or other foreign material or with gases 
and noxious vapors. The air in the pine woods gen¬ 
erally is considered the purest; but almost any place 
in the country will be satisfactory. The more 
densely populated a place the more will the air be 
contaminated, especially in cold weather when many 
fires are going and giving rise to wood smoke, coal 
gas, and other fumes. However, in sparsely popu¬ 
lated districts the other conveniences for treatment 
are not so readily available, and a compromise often 
is necessary. There is no perfect climate, and I 
know of no place which furnishes a perfect environ¬ 
ment for tuberculous patients. Hence, a certain 
amount of compromise always is necessary. And 
perhaps this is well, for if things were too easy for 
the patient he might not develop the necessary will 
power and wisdom to keep well after regaining his 
health. All obstacles have or can be made to have 
their uses. There are few climates so bad or few 
environments so unfavorable that the patient can¬ 
not get well if he employs the right treatment with 
determination and confidence. 

Outdoor living is always the best; but many pa¬ 
tients will not be in a position to live in the open. 
For these there are many methods by which the out¬ 
doors may be brought indoors, so to speak. Here I 
wish to tell you how to utilize the air once you have 
secured it. The orthodox treatment is unalterably 
111 


TUBERCULOSIS 


opposed to deep breathing exercises in the great ma¬ 
jority of cases, yet some people have recovered with 
very little treatment except deep breathing. Our 
physician friends emphasize the importance of rest 
for the lungs as well as for the rest of the body. The 
danger of rupturing the diseased lung tissues looms 
large in their minds. Some would stop the patient 
from breathing if that were possible,—and in ex¬ 
treme cases they do try to do just this, to a certain 
extent, by putting the patient’s chest in splints or a 
straitjacket and in other cases by collapsing an af¬ 
fected lung. As always, however, extremes are sel¬ 
dom advisable. There is a middle course to follow 
which, w T hile it may not give the maximum benefit to 
those cases which could stand extensive deep breath¬ 
ing, will do no harm to those who are not in a con¬ 
dition to stand much. One thing is certain, to sup¬ 
ply fresh air and then not use it is pure foolishness 
and no way to make progress. 

Having procured the air the next thing is to get it 
not only into the lungs but into the blood stream. 
It will be drawn into the lungs even with ordinary 
breathing; but before the essential elements can en¬ 
ter the blood stream there must be an interchange 
of gases through the air-cell walls and the blood-ves¬ 
sel walls. This takes a little time and is governed 
somewhat by the air pressure. If the air can be kept 
in the lungs a little longer than usual and under a 
slight pressure there will be a more perfect in¬ 
terchange of gases and, in consequence, better results 
will be secured. Merely taking deep breaths is not 
112 


CHRONIC PULMONARY TUBERCULOSIS 

entirely satisfactory. While it will ventilate the 
lungs it will not have great effect upon the blood 
stream. Moreover, there is some danger of tearing 
the diseased lung tissue and opening up tubercles 
through strain and unusual expansion of the parts, 
especially if there is a tendency to hemorrhage. 

The thing to do is to take a moderately deep 
breath, hold it for a few seconds and then let it out. 
This gets enough air into the lungs to reach all the 
air cells and keeps it in long enough to allow a free 
interchange of gases. The exact rhythm of this 
breathing will vary in individual cases. As a rule 
one should inhale for four or five heart beats, hold 
the breath for two, and exhale for four or five. 
The heart beats may be counted by placing the mid¬ 
dle finger on the pulse at the wrist until one learns 
the pulse rate through practise. The length of time 
for each part of the breath may be gradually in¬ 
creased until the inhalation takes seven beats, the 
retention four, and the exhalation seven. One of 
these breaths should be taken every hour during the 
day for three days, then two every hour, then three, 
and so on up to five. This number is continued for 
two weeks when it again may be gradually increased 
five more—up to ten. When able to take some 
muscular exercise the voluntary deep breathing need 
be taken only every two hours. 

It is well to use the power of thought along with 
breathing, as with eating. Think of the air as be¬ 
ing manifested life which you are drawing into your 
tissues where it may manifest as perfect cells and 
113 


TUBERCULOSIS 


perfect function. As you breathe in, visualize en¬ 
ergy flowing into you; as you breath out, visualize 
all the impurities flowing out of the body. Such 
conscious breathing will do wonders in cleansing and 
rejuvenating every tissue. Whatever else you do, 
do not neglect your breathing. Air is life to the 
tuberculous person, and it must be secured. 

SUNLIGHT 

In many respects, sunlight is almost as important 
as air. We do not fully realize its importance be¬ 
cause we always get a certain amount of it. If we 
were to be confined in a dungeon with little or no 
light we soon would begin to realize what part the 
sun plays in our existence. However, it is the direct 
unobstructed rays which are the most beneficial and 
helpful. Most people get little or none of these 
rays because all wear clothing and live indoors a 
large part of the time. Dr. J. A. Kiernan, of the 
United States Department of Agriculture, says that 
tuberculosis affects cattle in proportion as they live 
in the dark and under cover. If this is true for 
cattle, why not for human beings? As a matter of 
fact, there is no doubt that it is true in regard to 
humans, the facts being borne out by the observa¬ 
tion of the larger number of cases among poor 
people who live in dark, crowded quarters. But I 
have already given sufficient evidence of the im¬ 
portance of sunlight in the chapter on causes of tu¬ 
berculosis and need not repeat here. I also have 
told, in the chapter on treatment of acute cases, 
114 



S -4 V 

a 

4 -» 

XIX 

^ <u 

2 > 
_ 0 ) 
S3 o 
<u <u 

* u 

w *3 

-3 

4 -> O 
to cn 

• *H 

C/D 

o c 

f —H »H 

P 

o to 

1-4 

<D U-4 

•Q o 

3 

^ X! 

Mh £ 

o c 


<u 3 

u 3 
•TJ O 

c w 

<L> <,., 

Jc ~ 

^ C/D 
a_> 03 


. 3 
45 43 

4 -» 

5 ts 

•° c 
c o 

3 

to to 

to 

•a ^ 

(-« 

3 <D 

45 ’C 

H * 


115 


benefit of the healing rays of the 











TUBERCULOSIS 


how to take the sun baths. In the chapter on equip¬ 
ment I shall tell about various methods of getting 
the sun bath when one cannot simply go outdoors 
and lie down naked in a nice sunny spot. 

One point I wish to bring out here, however, is 
the matter of clothing. Of course, when the patient 
is in bed this is not of so much importance; but even 
under these circumstances the less clothing worn 
the better. If the climate permits, the patient 
should remain naked. All bed clothing should be as 
light as is consistent with warmth, and also should 
be light in color. White and orange are the best 
colors for all bodily coverings, as they permit the 
most light to pass through. White is the complete 
color and orange is the color of health. When 
there is fever light blue would be a good color, as 
it is cooling and soothing. The clothing should be 
loosely woven, as more of the rays can pass through 
the meshes. For this reason silk is not as good ma¬ 
terial as cotton or wool fabrics. Linen often is best 
of all. In cold weather the underclothing should be 
practically as light as in summer, adding more and 
heavier outer garments as may be required when 
going outside for walks, porch rest, or for any other 
purpose. These can be removed readily in accord¬ 
ance with the inside temperature. Moreover, sev¬ 
eral light coverings are warmer than one heavy one. 
As most people are rather limited as to the amount 
of sunlight they can get on their skin, it is very im¬ 
portant to wear the proper clothing in order that the 
deficiency may be made up as far as possible. Once 
116 


CHRONIC PULMONARY TUBERCULOSIS 


or twice a day all the clothing should be removed 
in order that the light and air may reach the skin. 
The only time this is not necessary is when the pa¬ 
tient is able to take sun baths regularly every day. 
The ultra-violet rays are a good substitute for the 
sun bath; but when neither can be obtained the air 
bath will give some of the desired results. 

It is greatly to be desired that either the sun bath 
or the ultra-violet radiations be secured by every 
patient until he is well on the road to recovery, and 
even for an indefinite time thereafter. The better 
blood, more energy, and greater resistance conferred 
by the sunlight are of the greatest possible assistance 
in recovery and eventually in establishing a complete 
cure. 


WATER 

Water is the most universal solvent, hence very 
important for cleansing. Since the body is three- 
fourths water, water also is highly necessary in the 
formation of the tissues. Not only that, but it is 
the most convenient carrier for heat or cold, being 
capable of altering to all temperatures from freez¬ 
ing to over 212 degrees. The latter is the boiling 
point, but steam is even hotter than boiling water 
while still being a form of water. Ice and salt will 
give a temperature below freezing. Water is ca¬ 
pable of a wide usage, and is most important to the 
tuberculous patient. 

The first use for water that naturally occurs to 
a person is that of drinking. Consuming consider- 

117 


TUBERCULOSIS 


able quantities of water while on the fruit diet will 
be of the greatest assistance in cleansing the alimen¬ 
tary tract, diluting toxins, and hastening their elimi¬ 
nation through the kidneys and skin. All this re¬ 
moves the fundamental cause of tuberculosis (toxe¬ 
mia), and fever is reduced and all symptoms amelio¬ 
rated. A glass of water an hour should be used, 
and even more may be taken. If there is difficulty 
in taking a full glass at a time a smaller quantity may 
be used, repeating the dose more frequently. Either 
hot or cold water or both may be employed, accord¬ 
ing to conditions and the desires. Hot water is 
heating and slightly more cleansing. Cool water 
generally is best when there is fever and for gen¬ 
eral purposes, since it is the natural temperature 
at which to take it. Ice-cold water should not be 
employed, even in very warm weather or high fever. 

The water should be the purest and best obtain¬ 
able. If the local water is very hard it may be well 
to dilute it with distilled water. It is never advis¬ 
able to use all distilled water. Special spring waters 
generally are very good, though not the nauseous, 
saline, iron, and sulphur waters. Use those brands 
which taste simply like “good water.” The proper 
kind of water is odorless, clean and sparkling. Boil¬ 
ing may be resorted to if the purity of the water 
is doubtful, after which it should be strained through 
a cloth and aerated by pouring back and forth from 
one vessel to another. While on the milk diet water 
need be taken only if there is a special desire for it, 
since the milk itself contains an abundance of water 
118 


CHRONIC PULMONARY TUBERCULOSIS 


—87 per cent. When on solid food the usual quan¬ 
tity of water consumed is six or eight glasses a day, 
taking it between meals. If there is definite thirst 
during meals a small amount of water may be taken 
at such times. 

Another use for water as an internal cleanser is 
the water injection into the bowels known as the 
enema. The high enema generally is employed on 
the first day of the fruit diet, then the ordinary 
enema daily thereafter until the bowels move natu¬ 
rally and regularly after starting the milk or solid 
food diet. After the fruit diet, however, the quan¬ 
tity and temperature of the water employed should 
be gradually reduced. It is not well to make a habit 
of taking the enema; but it should be employed 
whenever necessary, and this may be fairly regularly 
while the patient is confined to bed. When able to 
be up and around and do a little walking the activity 
will help greatly in keeping the bowels regular. If 
the bowels move of themselves but with difficulty it 
usually is best to use a small quantity of cool water 
as an enema. Straining at stool never is advisable, 
and particularly is to be avoided when there is a 
tendency to hemorrhage. 

It is extremely important that there be at least 
two bowel movements daily and three daily evacua¬ 
tions are still better. A regular time should be ob¬ 
served as nearly as possible. Occasionally it may 
happen that in severe cases of constipation the plain 
water enema will not be fully effective. In such a 
case a tablespoonful of salt may be added to each 
119 


TUBERCULOSIS 


quart of water. Epsom salts in the water sometimes 
is more effective than the ordinary salt. In getting 
the water out after injections, deep breathing and ab¬ 
dominal massage are very helpful. In the majority 
of cases there is not likely to be any special diffi¬ 
culty. Usually an enema of plain warm water will 
be readily taken and eliminated and prove fully sat¬ 
isfactory. Cool water often is ejected more easily 
and promptly than warm water. In any case, ex¬ 
cept of marked weakness, it is better to follow all 
warm enemas by small cool injections, these to be 
discharged immediately as were the warm enemas. 

The external application of water, as well as its 
internal use, is of value. We all know that it is 
necessary to keep clean; but there are other reasons 
for the external application of water. By the appli¬ 
cation of water at different temperatures we can 
heat or cool the body, stimulate or depress its func¬ 
tions, and control circulation. A thorough study of 
hydrotherapy in all its branches will show that 
practically all the actions of the body can be con¬ 
trolled through the use of water. Such absolute 
control is not always advisable, however. If a cer¬ 
tain condition is present in the body it usually is 
because that condition is necessary, and to change 
that condition without removing causes will result 
only in further trouble. Also, the arbitrary chang¬ 
ing of conditions uses up energy. However, if 
causes are being removed and intelligence is em¬ 
ployed in applying the water so as to exercise just 
enough control and not consume too much energy 
120 


CHRONIC PULMONARY TUBERCULOSIS 


water will be found of great assistance. In a case 
of tuberculosis energy must be conserved, since the 
patient is not in a position to build much for some 
time; hence, treatments of all kinds which consume 
energy should be kept at a minimum. Massage, 
enemas, baths, compresses, etc., all take energy and 
are to be used only when necessary. The sun bath 
confers energy; but even this important procedure 
can be carried to excess. 

In all cases of tuberculosis the daily tepid bath 
should be taken for cleanliness and refreshment. 
One or two warm baths with soap may be taken each 
week for additional cleanliness, especially if there is 
much sweating. The water should be just warm 
enough to be comfortable. Hot baths seldom if ever 
are given, except in the lighter cases when sun baths 
cannot be obtained and some additional skin elimina¬ 
tion is desirable. When sun baths are used a cool 
sponge should be taken afterward, this being the 
only water bath employed that day. If fever goes 
above 103 degrees, a cool sponge may be given. Of 
course, in such a case the sun baths will not be used. 

The local application of packs and compresses 
may be used to ameliorate symptoms when they be¬ 
come severe. This necessity arises only in chronic 
cases when complications develop, such as hem¬ 
orrhage, pleurisy, colds, insomnia, etc. 

EXERCISE 

While rest is very important in the treatment of 
tuberculosis, there comes a time when exercise is 
121 


TUBERCULOSIS 


not only permissible but necessary. To many ortho¬ 
dox practitioners exercise in tuberculosis includes 
nothing but walking; but there are other forms that 
also have their place and uses. Walking is the most 
valuable, without doubt; and many can do well with 
this alone until a fully normal condition has been 
restored. There has been much controversy as to 
the value of exercise for tuberculous patients. 
There was a time when the doctors recommended 
“roughing it.” A frequent prescription was, “Go 
out West and live on a ranch.” This “worked” in 
some cases, while others were made worse. Hence, 
at present there is a stronger and stronger trend 
toward the advice of rest and more rest. But the 
fact that activity proved beneficial in some cases 
indicates that there must be some value in it. It 
is simply a question of suiting the activity to the 
patient’s condition. Violent exercise, such as rowing 
and running races, have been advised in the past. 
Many times there seems to be an unusual “muscular 
intelligence” in tuberculosis, and tuberculous young 
men often are superior athletes—for a time, as 
many others have an unusually clear, perhaps bril¬ 
liant mentality. But such activity is to be con¬ 
demned. It cannot fail to hasten the course of 
tuberculosis. 

I would not have any of my readers reach the 
point where they are afraid to make a move. This 
often occurs when patients are taking the orthodox 
“cure.” They are especially impressed with the dan¬ 
ger of moving the arms. They require to be waited 
122 


CHRONIC PULMONARY TUBERCULOSIS 


on hand and foot, and would not think of lifting so 
much as a heavy book. They never seem to reach 
the point, however, where they will not use their 
arms to feed themselves. It may be well for women 
with long heavy hair (rare in these days of the 
“bob”) to avoid combing it themselves; but all ordi¬ 
nary movements are quite permissible. Of course, 
the more progress the patient has made the greater 
amount of activity will be permitted. The impor¬ 
tant points are to avoid sudden violent exertions, 
strain, or activity prolonged to the point of well 
marked fatigue. When there is any doubt about 
the amount and degree of exercise to employ it is 
safest to rest or use an insignificant amount and 
degree unless the patient can secure expert advice. 
However, one should not use this statement as an 
excuse for doing nothing. One always should take 
as much exercise as is felt to be safe. 

As I have stated before, it is always well to take 
about two weeks of rest at the start of treatment, 
even in the lightest cases. If there is fever, rest 
should be secured until several weeks after all fever 
has subsided. The temperatures governing this are 
as follows: 97.8 degrees at 7.00; 98.6 at 4.00; and 
98.2 at 8.00 to 9.30. If the temperatures exceed 
the figures given at the designated hours some fever 
may be assumed to be present. Much less trouble 
will be experienced with this symptom when taking 
the dietetic regimen I have advised. Fever is most 
persistent when following the orthodox method of 
overfeeding. 


123 


TUBERCULOSIS 


When ready to get up from the rest bed, couch 
or chair, the same plan may be followed that I have 
given in the chapter on acute cases and in this chap¬ 
ter under the discussion of rest. The first “Exer¬ 
cise” I would advise is the daily morning tepid 
(about 86 degrees) bath, soon changed to cool 
(about 68 degrees), and finally to cold (50 de¬ 
grees or lower)—each to be followed by brisk rub¬ 
bing to bring a glow to the skin. This is an admir¬ 
able exercise for lungs, heart, circulation, skin, 
muscles. When ready for regular walking out of 
doors the following plan is excellent: A five-minute 
walk daily on the first three days. This may not 
seem to be very much, but at ordinary speed it 
amounts to a quarter of a mile. Many a well per¬ 
son will reckon for ten minutes how many times he 
can change cars to avoid such a walk. It is best 
to regulate the walking by time rather than by dis¬ 
tance, on account of the varying speeds that will 
be used. The patients who have not been so bad 
and in bed only a short time can walk at regular 
speed. Those who have had more serious cases 
and have been quite weakened will have to walk 
slowly. The patient usually can judge his own 
speed best. A fairly level place should be selected 
and used until twenty-minute walks are being taken. 
If necessary, one may walk back and forth if the 
level spaces are limited. 

On the fourth day the walking time may be 
lengthened to seven minutes, and on the seventh day 
to ten minutes. On the tenth and following days 
124 


CHRONIC PULMONARY TUBERCULOSIS 


fifteen minutes may be spent in walking, and at the 
end of two weeks twenty minutes. This time should 
be adhered to for a week, when the distance again 
may be increased, five minutes per week until the 
walks are for one hour daily. When this has been 
done for two weeks a second daily walking period 
may be started, following the same plan as for the 
first one. At this time the longest period should be 
taken in the morning, the shorter in the afternoon. 
Of course they ultimately will become equal. 
Two hours of walking daily should be the maximum. 
If able to indulge in more activity than this it may be 
in the form of regular exercise. 

When able to take twenty minutes or more of 
walking, moderate hills may be selected, and as 
the condition further improves hills of steeper grade 
may be chosen. It is well to walk up hill at the start 
of the walk and down hill at the finish of the walk. 
It will be necessary to go slowly at first when climb¬ 
ing, as the breathing should not be greatly hurried. 
The amount of exertion required when walking 
varies with the speed, swing of the arms, amount of 
clothing, character of the ground, etc., and there 
are many gradations. Some can increase the exer¬ 
tion more rapidly than here suggested, and some 
will have to go more slowly. As a rule it is well to 
“make haste slowly.” If the patient is at all reason¬ 
able he will be able to judge for himself just what 
he can and cannot do safely. If too much is done 
on any day it may be well to rest a day before con¬ 
tinuing with the regular schedule. Indications of 

125 


TUBERCULOSIS 


over-activity are hastened pulse, palpitation of the 
heart, sweating, rise of temperature, weakness, dis¬ 
comfort in the chest, and headache. If increased 
heart action is the only symptom noticed the safety 
limit has not been overstepped. It is seldom that 
any difficulty will be experienced, as walking is such 
a rhythmic and natural exercise that one has to go 
considerably beyond the amount that would be 
proper before any noticeable harm will be done. 
When living rightly in other respects there is much 
less danger from over-exertion than when following 
conventional diet and treatment. 

The exercises that can be used in addition to 
walking are mild stretching and simple free-hand 
movements taken in a reclining position. For in¬ 
stance, in the reclining face-up position, raise and 
lower the head; cross the arms over the chest; flex 
and extend the arms; flex and extend the legs; raise 
and lower the legs one at a time; and with knees 
drawn up so that the feet are close to the buttocks* 
slightly raise the hips and lower again to position. 
Rolling from side to side also may be used. In the 
face-down position raise and lower the legs, and 
raise and lower the head and shoulders. These ex¬ 
ercises seldom are advisable until the patient is 
able to take at least an hour’s walk daily. In some 
cases they may be used instead of walking when the 
weather is so bad that the patient cannot get out. 
For instance, in the colder climates, the snow may 
be quite deep in winter, and this would greatly in¬ 
crease the exertion of walking, especially when tak- 
126 



Stand as shown. Inhale deeply; exhale by pressing on abdo¬ 
men, keeping chest fully elevated. Repeat five times; rest. 
Also start same position but inhale by pushing out abdomen, 
keeping chest flat. Repeat. Later learn to do both with arms 

at sides. 

127 







Stand with arms at sides. Raise both arms forward up¬ 
ward until vertical, inhaling. Hold the breath, stretch 
upward, rising on tiptoes. Lower arms sideward back¬ 
ward, palms up, pulling backward and exhaling. Repeat 
five a minute for twenty times. 

128 





Stand erect, arms down, feet together. Extend left foot for¬ 
ward at same time raising arms forward upward until ver¬ 
tical, inhaling deeply. Bend slightly backward. Lower arms 
sideward, exhaling, replacing foot. Alternate with feet, fif¬ 
teen to twenty times. 

129 




Stand erect but with arms forward, palms together. Swing 
both arms outward backward, inhaling. Turn palms outward 
at start of movement. Bring arms forward, exhaling. Bend¬ 
ing slightly forward on inhaling movement improves the 

movement. 

130 













This is a friction-resistance-breathing exercise. Stand in posi¬ 
tion shown. Press firmly with hands and wrists and move 
them to and fro across the body while inhaling deeply, then 
while exhaling. Pause between inhaling and exhaling. Rest 
and repeat. 

131 










Stand erect, holding a wand or slender stick across the thighs 
in front. Raise wand to overhead, inhaling; increase depth o£ 
breath while lowering wand to shoulders as shown. Exhale 
as wand is raised to vertical and brought down to starting 
position. Repeat. 

132 






Stand erect, arms at sides. Inhale deeply, then bend down 
slowly and fully exhale. Now come to erect, bringing arms 
forward upward overhead, letting them go outward backward, 
palms up, inhaling deeply. Bend forward, exhaling, and repeat. 

133 




Rest weight on one knee and the other foot, hands on hips. 
Bring arms forward upward backward, inhaling deeply. Come 
to erect and return hands to hips, exhaling. Repeat. Then 
reverse positions of feet and knees and repeat. 

134 






Stand erect, hands on hips. Bend the head sidewise as far as 
possible, right and left. Then bend head forward and back¬ 
ward as far as possible. Then rotate head right and left, look¬ 
ing over shoulders. Breathe slowly, deeply and rhythmically. 

135 










Stand erect, hands locked behind head (or neck). Bend right 
slowly, inhaling deeply, stretching the left side of chest and 
expanding it fully. Come to erect, exhaling; then bend left, 
stretching right side of chest. Continue alternating right 
and left. 

136 





Stand erect, left hand on hip, right arm down. Bring right 
arm outward upward to overhead and bend left, inhaling and 
stretching right side of chest. Press into side with left hand. 
Return to erect, lowering right arm, exhaling. Repeat, then 
reverse and repeat. 

137 













Stand erect, hands on hips. Raise right knee high, lower, and 
repeat. Then raise left knee similarly. Then alternate right 
and left. Breathe rhythmically, inhaling as knees ascend, 
exhaling when lowering knees. 

138 





Stand erect facing an attendant, whose hands rest on top 
of the arms folded across abdomen. Inhale deeply while 
raising arms as high as possible, attendant resisting the 
movement. Lower arms and exhale, without resistance. 

Repeat. 

139 










Stand erect facing an attendant, the arms folded in front 
of face, resting on the hands of an attendant. Inhale 
deeply while lowering arms to abdomen, attendant re¬ 
sisting the movement. Raise arms and exhale, without 
resistance. Repeat. 

140 












V >'• 

So. 

O <0 

' QJ 

£ b0 
+2 C 

*d c 

c -a 

<D . 

4 -> <U 

g!3 

O) 

l-l ^ 

<L> . 

M43 
G ° 

£ g 


8 8 

•S £ 

Sr* 

> u 

O 3 


03 

<U 

a 

<u 


CO 


° « 


co 

<u 


g fi . 

^ o bo 

rt '42 C 

73 0 3 

C £ C3 

£ C J3 

X bO g 

w.s " 

Ui r -3 

• <L> *S 
■4-» > 42 
CO J> > 

O o ^ 

° -d 

o c c 

03 *J3 

r2 M h 

c .5 o 

03 10 *+■< 
mm* • H 

^ jfl c 

Ih a> 
43 

4-» CO 4 IJ 

• H 

^ - 4 -* 

'■d <u 

<U M 
g Cd 

<U k—i 

W § 

to 

£ c 

is .2 


to 

O 

& 

bO 

C 

> *H 

4 -» 
U 

be 5 

C to 

• H 

J 0 

h -3 -M 


44 

o 

03 

42 

C 

O 


141 














142 


Lying on back, arms at sides, knees flexed with heels near hips. Raise hips as high as possible, inhal¬ 
ing deeply. Hold the hips high while completing the deep breath. Then lower and exhale. Repeat 

several times. 










143 


Lying on the back, arms at sides, legs extended. Raise the right leg, knee straight, as high as possible. 
Lower, and repeat. Then raise left leg similarly. Then alternate right and left. When strong enough 

raise both legs together. 







































144 


Lying on the back, legs extended, arms folded across upper abdomen. Raise head and shoulders, as 
shown. Lower, and repeat. When stronger rise to sitting position. If necessary, place feet under 

some support. 
















145 






Lying face down, arms folded beneath the chin, or extending alongside the body. Raise the left leg, 
knee straight, as high as possible; lower, and repeat. Then raise right leg. Then alternate left and right 

When stronger raise both legs. 






























146 


Lying face down, palms on floor beneath shoulders. Press upward with arms, raising trunk until arms 
are straight, inhaling deeply. Bend arms and lower trunk, exhaling. Relax a moment and repeat a 

few times. Later raise hips also, resting on hands and knees. 















CHRONIC PULMONARY TUBERCULOSIS 


ing fairly long walks where one would be inclined 
to get away from the cleared spaces. Within rea¬ 
son, however, the patient should not allow the 
weather to deter him from going out for at least 
half an hour every day. 

When using the general exercises they always 
should be started with an amount that is easy to 
perform and increased gradually in accordance with 
the patient’s strength and progress. The maximum 
time spent in doing these exercises should not ex¬ 
ceed twenty minutes. Rest from general exercise 
always should be observed two days a week (pref¬ 
erably not together) for the first month and one 
day a week thereafter. No matter what form of 
exercise is used it should always be balanced by 
plenty of rest and sleep, as advised in the section 
on rest. The statement above in regard to symp¬ 
toms of over-exertion applies to general exercises 
as well as to walking. 

When all symptoms of the disease have subsided 
and the exercises already described can be taken 
without difficulty, more strenuous movements may 
be adopted gradually so as to increase the strength 
and endurance up to normal. Many tuberculous pa¬ 
tients whose cases have become “arrested” on the 
usual rest cure treatment continue to avoid all exer¬ 
tion for years, with the idea that they are thereby 
preventing a recurrence. This may be advisable, at 
that, when they are simply “arrested” from the con¬ 
ventional treatment. But when they have been 
really cured by having the causes removed by nat- 
147 


TUBERCULOSIS 


ural methods of treatment they should gradually In¬ 
crease their activity until they reach the athletic 
stage. There will be no danger of recurrence so 
long as they live rightly. 

RIGHT THINKING 

Practitioners of all schools agree that the mental 
attitude of the tuberculous patient is very impor¬ 
tant. It has been said that these patients are in¬ 
clined to be over-optimistic and, in consequence, to 
neglect treatment. I am inclined to believe that this 
would be preferable to pessimism, with the most 
careful treatment. In fact, it is impossible to use 
the right treatment unless the mental side of the 
patient is considered. The body has often been com¬ 
pared to a machine—and with reason; but we must 
not allow ourselves to fall into the error of assum¬ 
ing that that is all it is. There is the engineer to 
be considered. We must treat the patient rather 
than the disease. That is why the general treat¬ 
ment always must be adapted to individual needs, 
and it explains why some people get well and others 
die. Those who die usually do so because they have 
been thinking wrongly. They may have been un.- 
willing to take care of themselves; or they may have 
allowed themselves to lose hope; or they may have 
prevented their progress by continual ill temper; or 
in a few cases they may have actually desired to die. 
All action is preceded by thought; and the thoughts 
must be right if we are to secure results in the 
treatment of disease. 


148 


CHRONIC PULMONARY TUBERCULOSIS 


The general mental attitude should be hopeful, 
confident, trusting, cheerful, and patient. The pa¬ 
tient must accept the fact that he has to atone for 
his former wrong habits of living. He should re¬ 
solve to pay the costs as quickly as possible by strict 
application to the business of getting well. Above 
all, he should avoid self-pity, for patients who in¬ 
dulge in self-pity are almost beyond help. The nat¬ 
ural state of the body is health. The body always 
is trying to be healthy; and if it is given a chance 
it always will be so. Hence, there is no cause for 
doubt or fear. The patient can look forward with 
confidence and trust to the time when he will be 
well once more. This should make him patient and 
cheerful. Impatience causes tension, which inter¬ 
feres with circulation and wastes nervous energy. 
Depression inhibits all the functions of the body. 
The emotions can quickly disturb the most vital proc¬ 
esses. Therefore, they should be kept carefully 
under control. This can be done if the patient will 
learn to relax and will practise the right kind of 
thoughts. 

Thorough mental and physical relaxation should 
be practised for a few minutes several times during 
the day, and always just before going to sleep at 
night. The breathing should be slow and deep. 
As you relax realize that you are removing every 
conscious interference with the healing forces in 
the body. Give yourself up completely to the guid¬ 
ing subconscious intelligence which knows far more 
about how to run the body than your conscious self 
149 


TUBERCULOSIS 


does. Have confidence in this power and you will 
feel much better after your period of relaxation and 
will certainly make more rapid progress. 

If especially inclined to think destructive 
thoughts, there are several exercises that may be 
used after the period of relaxation. One is the 
well-known autosuggestion. This consists in re¬ 
peating a number of constructive thoughts from 
three to seven times each. These thoughts need 
not be couched in religious or scientific terms, but 
may be put in any form that suits the patient. The 
particular ones used will depend on the needs of the 
patient. If he is homesick he may say, “Distance 
is only a relative term and has no actual existence. 
I am now at home in spirit.” Then he may visualize 
home surroundings—though often this makes it 
more difficult to combat homesickness. If he is de¬ 
pressed he may say “This, too, shall pass. It is 
always darkest just before the dawn. I can even now 
feel new life and energy growing within me.” If 
he is inclined to worry he may say “All power is 
mine to use. I have only to open myself to its in¬ 
flow. I feel new courage and confidence.” When 
irritable and impatient he may say, “I am poise, 
and I have peace. I desire all good for others even 
as I desire it for myself. I will see, hear, and speak 
only the good.” There is an infinite variety of 
these good thoughts, and the patient or some sym¬ 
pathetic friend easily can formulate the ones which 
will especially appeal. It is well to memorize the 
ones that are to be used regularly. After a little 
150 


CHRONIC PULMONARY TUBERCULOSIS 


practise the patient will be able to extemporize—to 
form new thoughts at will. Then he will find it 
much easier to avoid the destructive thoughts which 
are interfering with his progress. It may take a 
little time and effort, but the habit of right thinking 
can be developed the same as can the habit of wrong 
thinking. Great care must be observed not to give 
counter-suggestion to the helpful ones. Sayings 
such as “I am not ill,” “I shall not let people irri¬ 
tate me,” etc., serve only to give to the subcon¬ 
scious mind just the impression you do not want 
it to carry. 

Another excellent practise after the period of re¬ 
laxation is to send out thoughts of love to every 
one, including not only those for whom there is a 
real liking, but also those whom you think you do 
not like. Our so-called enemies are really our 
teachers, and through loving them we can transform 
them into friends. This practise has very far- 
reaching effects. But the ones which will be most 
readily understood by most persons are the con¬ 
structive and harmonizing effects. If one is con¬ 
tinually thinking thoughts of love it is easy to see 
how destructive thoughts and emotions will be ban¬ 
ished. Love is the most powerful constructive force 
in the universe, and concentration upon it is certain 
to have a constructive effect upon the body. This 
comes about through the harmonizing effects. Most 
of our mental disturbances arise from fears and 
dislikes. These cause tension, irritation, and in¬ 
ternal conflict. But if we constantly think thoughts 

151 


TUBERCULOSIS 


of love all will be harmony, peace, and relaxation. 

Another valuable exercise is to visualize yourself 
as doing the things you want to do and being what 
you want to be. Most people’s desires are inher¬ 
ently good, and thinking about them will keep the 
mind so occupied that there will be less tendency 
toward destructive thoughts. Visualizing good 
things also intensifies the desire for them, and one 
will be more inclined to work to bring the dreams 
true. The very fact that one is thinking about these 
things tends to attract them. So visualize health, 
strength, poise, power, control, happiness, and 
success. 

Consciously use the mind in all things. As you 
breathe think of what the air is doing for you; as 
you take water think of its value; as you take food 
visualize the life in it adding to your life; as you 
exercise think of your growing strength; and just 
before you go to sleep think of all the repair and 
rejuvenation that are to take place during the hours 
of rest. Back up your physical efforts by mental 
efforts and better results will be secured. Always 
avoid tension, however. The best results are se¬ 
cured when we think the right thoughts calmly, 
gently, trustingly, and almost without effort. 

DAILY REGIMEN 

As the successful treatment of chronic tubercu¬ 
losis depends upon regular, careful, persistent ob¬ 
servance of definite health rules, a daily regimen, 
without doubt, would be of assistance to those who 
152 


CHRONIC PULMONARY TUBERCULOSIS 


are going to apply the treatment suggestions I have 
just described. Of course, no hard and fast rules 
can be laid down, as each patient must be considered 
an individual, and due allowance must be made for 
his condition, temperament, and environment. 
However, the following plans will be found to apply 
in most cases. 

While resting in bed: 

Wake at 7.00 A.M. (optional; but keep corre¬ 
sponding hours if this awakening time is changed). 

Take a few deep breaths, as has been described. 
(Repeat these every hour.) 

Cleanse mouth and teeth. 

Glass of water or juice of an orange or a whole 
orange, depending upon diet being used. 

Start milk at 7.30 A.M. 

If on orange diet, go according to previous di¬ 
rections. 

If on solid food, take breakfast at 8.00 A.M. 

Rest until 10.00 A.M. 

Sun bath, cool bath, and enema if needed. 

Rest, especially from 12.30 to 1.00 if on solid 
food. 

Lunch at 1.00 if taking solid food. 

Rest. 

Additional sun bath at 3.00 if condition warrants 
it. Other special treatments instead of sun bath if 
they are indicated. 

Dinner at 6.00 if on solid food. 

If on milk, the day’s quantity should be finished 
153 


TUBERCULOSIS 


by 7.00 p.m. (Milk may be taken during sun oaths.) 

Cleanse mouth and teeth at 8.30 P.M. 

Few deep breaths (these should have been taken 
regularly during the day). 

Sleep at 9.00 p.m. 

While up and around: 

Rise at 7.00 A.M. (see above). 

Take a few deep breaths. (Repeat every hour.) 

Cleanse mouth and teeth. 

Glass of water and juice of one or two oranges. 

Dress. 

Start milk at 7.30 A.M. or rest until 8.00. 

Breakfast at 8.00 if on solid food. 

9.00 to 11.00 A.M., take sun bath and cool bath, 
resting at same time. 

Walk at 11.00. 

Rest 12.00 to 1.00, if on solid food. 

Lunch at one, if on solid food. 

Rest in bed 2.00 to 4.00, or take additional sun 
bath if permitted. 

Additional walk at 4.00 if permitted, or other 
exercise. 

Dinner at 6.00, if on solid food. 

If on milk the day’s quantity should be finished 
by 7.00 p.m. 

Cleanse mouth and teeth at 8.30 p.m. 

Few deep breaths. 

In bed at 9.00 p.m. 

When rest is mentioned it means complete rest, 
either in bed or in a recliner. One hour of the 


154 


CHRONIC PULMONARY TUBERCULOSIS 


afternoon rest period should be spent in sleep if at 
all possible. There should be a minimum of talking 
during rest periods. 

Any time which is not specifically occupied may 
be spent variously, depending upon the patient’s 
condition. Some will need to rest during these 
periods, also. Others may read or write or receive 
visitors. Some of this time always should be used 
for mental concentration and autosuggestion. The 
more improved cases may stroll around, or visit bed 
patients (if in a sanitarium) or play croquet or 
cards or other games requiring little exertion. The 
theater is occasionally permissible—but for the com¬ 
posure of others, who still may have fears of the 
contagiousness of the disease, all gatherings should 
be avoided if there is coughing and expectoration. 

When there is fever the thermometer readings 
should be taken every two to four hours, depending 
upon the condition. As a rule, the longer periods 
will be sufficient. The pulse, also, is taken at these 
times. As soon as possible these tests should be 
discontinued, as they tend to keep the patient’s at¬ 
tention concentrated upon his symptoms. 

Some time necessarily will be consumed in attend¬ 
ing to the bowel and kidney actions. The bowels 
should be solicited at regular periods during the day 
—at least twice, preferably three times. If on solid 
food, just after meals will be the most favorable 
times. The same hours may be observed if on the 
milk diet. 

As little time as possible should be spent in dress- 
155 


TUBERCULOSIS 


ing and undressing. The clothing should be very 
simple and easily managed. The women should not 
spend much time in special beauty treatments, even 
if given by an assistant. The moderately advanced 
and advanced cases should always have some one 
else shampoo the hair until they have greatly im¬ 
proved. In the case of women, bobbed hair is more 
easily cared for, and is much more satisfactory. 
The men should shave their beards or be shaved 
regularly. 

All these little things, while seemingly unimpor¬ 
tant, should be considered. The living habits as a 
whole should be as simple and natural as possible, 
dispensing with practically all social formalities, ex¬ 
cept those positively indicated by good taste. How¬ 
ever, the tuberculous patient will or should have 
little occasion to pay attention to social niceties and 
requirements. His business is that of getting well, 
and that only. The more he is interested in social 
obligations the more will his progress be retarded. 


156 


CHAPTER VIII 

Treatment of Laryngeal and Intestinal 
Tuberculosis 

^RYNGEAL and intestinal tuberculosis are usu- 



ally secondary to pulmonary infection. Occa¬ 
sionally they may seem to appear simultaneously 
with the lung affection, and once in a while before. 
However, whether it appears before, with, or after 
the pulmonary infection, the same general treat¬ 
ment will apply, because the same causes operated 
to produce the trouble, and these must be removed. 
The same general symptoms of loss of weight, 
weakness, fever, night sweats, etc., are present. 
But there are special symptoms, referable to the 
parts affected, as has already been described in the 
chapter on symptoms. These special symptoms re¬ 
quire various modifications in the general treatment 
and of other special measures, and it is to these I 
will give attention in this chapter. 

When these parts of the body are affected in ad¬ 
dition to the lungs the condition is always more 
serious, and special care will be needed. The em¬ 
phasis should be placed upon rest, fresh air, and 
sunlight or ultra-violet radiations. Remember that 
the forces of Nature are most powerful. Never 


157 


TUBERCULOSIS 


lose confidence in them. Jumping from one “cure” 
to another in the vain hope of finding something 
that will give quick relief generally will result not 
only in disappointment but in the case becoming 
worse. Be quiet, relax, avoid tension, trust Nature 
and give her a chance. 

LARYNGEAL TUBERCULOSIS 
Rest in these cases involves not only the body but, 
also, the voice. This voice rest is of the greatest 
importance. Every sound that is uttered causes 
movement and vibration of the larynx and vocal 
cords, and when they are inflamed and ulcerated 
this not only increases pain but hinders healing. In 
the lighter cases it may be sufficient to limit articu¬ 
lation to whispers; but in the more marked cases 
absolute silence should be observed. Even in the 
lighter cases it is well to refrain from using the 
voice for several weeks. Whenever it is desired to 
convey some message to another it should be writ¬ 
ten on paper or a slate. If whispering is allowed it 
should be limited absolutely to necessary conversa¬ 
tion, and the effort to make people hear at a dis¬ 
tance should be avoided. The throat can be strained 
or irritated by a whisper as well as by loud speaking. 

As the patient probably will be confined to bed 
for some time when the throat is affected, proper 
arrangements should be made for calling attendants. 
A small table bell usually is the most convenient. 

It is usually well to continue whispering until all 
throat symptoms have subsided, and in severe cases 
158 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 


for several weeks thereafter. Then talking may be 
resumed gradually. First, the patient may be per¬ 
mitted to speak greetings. A “Good morning!” 
aloud after a considerable period of silence will 
have a wonderful effect on all concerned. After a 
few days of gradual addition of words the patient 
may be allowed to carry on a conversation for five 
minutes. It is surprising how much can be said in 
five minutes; but the patient should not monopolize 
all this time, but should give the other person a little 
chance. In three days more the speaking time may 
be extended to ten minutes. After a week of this 
the patient may be permitted to make all necessary 
remarks aloud, but without any special period of 
conversation. After another week the five-minute 
period of conversation may be resumed, and then a 
gradual return to normal talking may be allowed, 
graduating it in accordance with the progress of the 
patient. If any soreness of the throat develops 
silence should be observed for a day or more. 
When the proper treatment has been used to remove 
the causes of the trouble, however, there should be 
no relapses. 

There are two other factors besides talking that 
need to be considered in giving rest to the throat. 
One is coughing, the other is choking. There is cer¬ 
tain to be some coughing, and because of the throat 
inflammation there is quite likely to be more than 
usual. Rest, fresh air, and proper diet will do much 
to reduce this, but, also, the patient should make an 
effort to suppress all unnecessary coughing. If 
159 


TUBERCULOSIS 


there is great irritation and voluntary suppression 
is difficult or impossible, some of the special treat¬ 
ments to be mentioned a little farther on may be 
used, such as cold packs, sucking ice, local anes¬ 
thetics, etc. 

Owing to the great swelling which often is pres¬ 
ent in these cases and to the contraction of the parts 
from pain, there is considerable danger of choking 
while eating. The least little thing that gets into 
the larynx will cause great distress and most violent 
coughing, which is a serious strain on the diseased 
parts. When the epiglottis is swollen it may not 
close as it should, and this increases the difficulty. 
Precautions to be observed are thorough mastica¬ 
tion and rapid swallowing. After having prepared 
the food for swallowing it should be bolted quickly. 
In taking liquids, however, it is usually best to swal¬ 
low them a mouthful at a time rather than to try to 
drink down a cup or glassful rapidly. Individual 
cases vary somewhat, and the particular manner of 
eating which seems to be the easiest should be em¬ 
ployed. One thing which always helps is to lean 
forward when swallowing. This allows the larnyx 
to drop forward so that it is less in the way and the 
food has a freer passage into the esophagus. Severe 
cases or a case where this symptom disturbs severely 
may have to lie flat on the stomach when eating or 
drinking milk. 

The soreness and ulceration of the parts may 
make them very sensitive to acids. In such cases it 
may be well to use vegetable broth instead of acid 
160 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 

fruits. This may be made of celery, cabbage, 
onions, and carrots. It may be difficult to handle 
tomato, but if possible to take it, this may be added 
to the broth. It is a very valuable food. A little 
garlic, also, may be employed in the broth. 

If unable to take the more acid fruits when on the 
milk diet, it may be possible to use peaches, pears, 
ripe apricots, and raspberries. Rarely is vegetable 
broth so satisfactory as acid fruit with the milk. 
Sometimes fruit juice may be taken in gelatine. The 
milk should be used if at all possible, as it is the 
most effective diet. If easier to swallow solids than 
liquids, some of the milk may be taken in the form 
of junket—milk coagulated with rennet. (Junket 
tablets may be procured in most drug stores.) If 
there is a great difference in the comfort with which 
-solid foods and liquids may be taken, and in favor 
of the former, a solid food diet may be employed 
for a time. In most cases the broth diet and other 
measures will reduce the pain sufficiently to permit 
of the use of the milk. When there is severe pain 
it may be well to fast absolutely for a few days 
rather than to take either fruit juice or vegetable 
broth. 

Fresh air is, if possible, more important than ever 
when the larnyx is affected. The swelling of this 
organ makes it difficult to breathe, and what air is 
secured should be as fresh as possible. Moreover, 
fresh, clean air will make it easier to breathe. Dif¬ 
ficulty in breathing is one of the most distressing 
symptoms encountered in severe cases of laryngeal 
161 


TUBERCULOSIS 


tuberculosis. Some patients may find it impossible 
to lie down. At night the greatest degree of in¬ 
clination that comfort will permit should be em¬ 
ployed, because it will be easier to sleep—and sleep 
is life to such a patient. A few hours’ rest from the 
pain and torment means a great deal. During the 
day the patient can sit up if necessary. In cold 
weather care must be observed to keep the patient 
well wrapped to avoid chilling, and the air may be 
warmed somewhat; but there must be no curtailment 
in supply. The body is in a position to develop 
colds at such a time; but the symptoms of a cold 
may make matters so much worse as to be very 
serious. Hence, they should be avoided as far as 
possible through keeping an even body temperature, 
in addition to the constitutional treatment. These 
cases may find cool air easier to breathe than warm 
air, but very cold temperature is seldom well toler¬ 
ated. A temperature of approximately 60 degrees 
will be favorable in most cases. 

One of the most important factors in laryngeal 
cases is sunlight. I mean not only the usual general 
sun baths, but sunlight in the throat. In severe 
cases the heating effect of the general sun bath may 
increase the throat symptoms, in spite of the use of 
cold neck packs or drinking cold water or the general 
cold bath. In such cases it may be necessary to avoid 
them. General ultra-violet radiations will make a 
good substitute. In the throat itself, however, the 
sunlight is most excellent and can always be toler¬ 
ated. In localities where there is little sunlight, 
162 



LARYNGEAL AND INTESTINAL TUBERCULOSIS 

localized ultra-violet radiations may be used in part, 
but the natural sunlight should be secured whenever 
possible. If there is much ulceration the occasional 
use of ultra-violet locally may be of additional as¬ 
sistance even though the sunlight can be secured 
regularly; but it will not be absolutely necessary. 
The disadvantage of such local radiations is that 


Local radiation to the throat with a mercury-quartz ultra¬ 
violet ray water-cooled lamp, especially designed for local 
treatment of the orifices of the body. 

they require a special lamp, which is not always 
possessed even by throat specialists. The treat¬ 
ments must always be given by a doctor who under¬ 
stands the use of the lamp and its application in 
such cases. 

The natural sunlight, on the other hand, can be 
applied by the patient, and with a few simple pre¬ 
cautions cannot do any harm. For the application 





TUBERCULOSIS 


of the rays special reflecting mirrors will be re¬ 
quired. These may be obtained in a combination of 
aluminum and magnesium, which is more efficient 
than ordinary glass for the reason that it reflects 
more of the ultra-violet rays and absorbs (keeps 
from the tissues) some of the heat rays. The ap¬ 
paratus consists of two large mirrors on a standard 
which is to be fastened to the back of a chair. One 
mirror is of glass, for observation, and the other is a 
concave composition mirror, for focusing and con¬ 
centrating the sun’s rays. There also is a small 
composition mirror with a long handle for insertion 
into the throat. The patient sits with his back to 
the sun, holds his tongue out with one hand by 
grasping the end of it with a piece of gauze between 
his fingers, and places the small mirror in the throat 
with the other hand. He then maneuvers into a 
position which will permit the sun’s rays to fall on 
the focusing mirror and be reflected to the small 
mirror and then down into the larnyx. A little 
practise will soon determine the position to use, and 
the necessary adjustment of the mirrors. Holding 
the tongue out is somewhat difficult, but here again 
practise will bring results. The use of sunlight is so 
important that some discomfort should be tolerated, 
if necessary. 

The first exposure is for one minute, thirty sec¬ 
onds at a time, with a short rest between the two. 
Exposures are to be increased one minute per day to 
three minutes. After three days this should be in¬ 
creased in the same way up to ten. minutes. Usually 
164 



LARYNGEAL AND INTESTINAL TUBERCULOSIS 

this is the maximum, but a few cases may use two 
such exposures per day, taking one in the morning 
and the other in the afternoon. A short rest in- 


Natural sunlight radiations of the larnyx by means of special 
reflecting and focusing mirrors. The instrument being held in 
the mouth is a small throat mirror. 

tervenes between each two exposures of thirty 
seconds each. After some practise it will be pos¬ 
sible to expose the parts one minute at a time before 
a rest will be required. The rate of increase always 

165 



TUBERCULOSIS 


depends upon the patient’s reactions. Some may 
have to increase more slowly than I have recom¬ 
mended. If there is a slight burning, a rest of a 
day or two should be observed. A half glass of 
quite cool water may be taken slowly after the 
treatment. 

The application of a cold neck pack after treat¬ 
ment is helpful. This should be used quite fre¬ 
quently in any case. It may be applied every night 
for a week, then every other night for a week; then 
the same over again, continuing indefinitely. In se¬ 
vere cases it may be applied two or three times a 
day for periods of two hours each. The pack should 
be applied as follows: Secure a muslin or linen 
cloth long enough to go around the neck and wide 
enough to fold into several thicknesses, about three 
inches wide. This is wrung out of cold water and 
applied quickly and snugly to the neck, but not tight 
enough to interfere with circulation. It is imme¬ 
diately covered with a dry woolen cloth which has 
been previously prepared, and the whole secured in 
place with safety pins. The woolen cloth should be 
somewhat wider than the wet pack so as to cover 
completely and exclude all air from it. A piece of 
old blanket is good to use, or two thicknesses of any 
flannel cloth. The pack should become warm from 
the natural warmth of the skin, within a few minutes 
after application. It will do this if the wet pack is 
not too thick, if it is wrung fairly dry, and if both 
cloths are fitted snugly. 

The measures already mentioned will be sufficient 
166 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 


in the great majority of cases. However, in the 
more severe cases and those which have been neg¬ 
lected or wrongly treated it may be necessary to 
employ some special measures for the relief of 
symptoms, while at the same time adhering closely 
to the constitutional treatment for removal of fun¬ 
damental causes. These special measures include 
sprays and drops for the throat, inhalations, local 
anesthetics, and cauterization. 

Spraying the throat is of value for cleanliness and 
antisepsis. There usually is much mucus in the 
throat when it is inflamed, and the necessity for fre¬ 
quent clearing of the throat is a strain on the parts. 
Spraying will cleanse these parts so, that for a time 
at least, they will have rest. The relief afforded the 
patient also saves nervous energy. There is danger, 
however, of too much spraying, which may lead to 
further irritation. In most cases twice per day will 
be sufficient. An atomizer with an adjustable end 
which can be bent downward should be used, in 
order that at least some of the spray may reach the 
larynx. An alkaline spray will be best. There are 
a number of these on the market. Plain salt water 
may be used also. Usually a spray with an oil base 
will be preferred, however, as it is more soothing. 
The fluid should be non-irritating, in order that it 
cause no pain. 

In order to affect the larnyx directly, a similar 
preparation may be applied by dropping it into the 
larnyx with a special laryngeal dropper. Such a 
dropper has a long tube with a curved end, which 
167 


TUBERCULOSIS 


should be Inserted well down into the throat. Just 
a few drops, of any chosen preparation, will be suf¬ 
ficient. When the purpose is cleanliness the same 
fluid used for the spray may be employed. If there 
is ulceration of the larnyx, preparations containing 
menthol, camphor, or eucalyptus will be not only 
cleansing but will give some relief from pain, though 
there will be some slight stinging sensations for a 
few moments. These drops may be employed one, 
two or three times a day. If spraying is also being 
used, the drops may be placed in the larnyx just 
after the throat has been cleansed by the spraying. 
If there is much swelling a solution of adrenalin 
will produce a little shrinking. But this should be 
employed only in extreme cases and no longer than 
is absolutely necessary, and it should be used only 
as prescribed by a physician. 

Often the swelling of the larnyx will interfere 
with breathing, in which case inhalation of one of 
various vapors may be used for temporary relief. 
Those most commonly employed include the various 
combinations of tincture of benzoin, pine oil, men¬ 
thol, etc. The use of these can be easily overdone, 
as the vapor also reaches the lungs, where too much 
of it will produce irritation. Such an inhalation 
need be used only before retiring, in most cases, 
to assist the patient in getting to sleep through the 
temporary relief afforded. It should not be con¬ 
tinued any longer than is necessary. 

There is a form of inhalation, however, which 
will benefit not only the larnyx but the lungs, also. 

168 ' 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 


This is much akin to fresh air, the king of all in¬ 
halations. It is called Terpezone, being a combina¬ 
tion of the vapor of refined turpentine (from pine 
tree and ozone). It is non-irritating, and gives much 
relief through its cleansing and antiseptic effects. 
Unfortunately, this treatment is only just being de¬ 
veloped and is not yet used widely enough to be 
readily procurable by all patients. Though prac¬ 
tically always of assistance, it is by no means such a 
necessity as are fresh air, sunlight, proper food, etc. 

One of the most distressing symptoms asso¬ 
ciated with laryngeal tuberculosis is pain. Often 
this is very acute and very constant, and disturbs 
the patient greatly. In so far as possible it should be 
ignored, and dependence for relief placed upon 
fresh air, silence (throat rest), sunlight, and cold 
neck packs. In neglected cases, however, it may be 
so disturbing as to call for more drastic measures, 
such as the use of local anesthetics. These give a 
very transitory relief, and some of them are toxic. 
They should be employed only as a last resort and 
only for as long as is absolutely necessary. Prob¬ 
ably the least toxic ones are orthoform and anes- 
thesin. These are in powder form and are sprayed 
into the larnyx with a powder blower, inhaling at 
the same time. Sometimes it will be more effective 
to combine the powder with olive oil and drop it 
into the larnyx with a laryngeal dropper. These 
preparations should not be used repeatedly as soon 
as the effect of each application wears off. They 
should be employed only for a specific purpose, such 
169 


TUBERCULOSIS 


as to lessen pain while eating or to give the patient 
a chance to get to sleep at night or occasionally in 
the afternoon. When the proper general treatment 
is being used, and especially when sunlight is being 
reflected into the larnyx, there will soon be sufficient 
relief to make the anesthetics unnecessary. When 
these are used they should be prescribed by a phy¬ 
sician in order that proper quantities may be em¬ 
ployed for perfect safety. 

In the most extreme cases, where there is much 
swelling and ulceration, there is one final thing that 
may be tried. This is the galvano-cautery. It is 
used with local anesthesia by cocain. The white-hot 
needle is plunged directly into the swollen cartilages 
and is used to sear the ulcers. The burning causes 
the formation of scar tissue, which in time shrinks, 
thus reducing the laryngeal swelling. The cauteri¬ 
zation sterilizes the ulcers. This treatment must 
be used with the greatest care, and only a thor¬ 
oughly qualified operator should be employed. 
There is danger of causing too much scar tissue with 
closing of the throat. In treating ulceration on the 
vocal cords by this method there is danger of doing 
them permanent injury. When properly done, 
however, the treatment may be of value in severe 
and critical cases. Pain and general discomfort are 
always increased for about a day after treatment, 
but after that there is relief. The frequency of 
treatment will depend upon the exact condition. It 
never should be done any more frequently than is 
absolutely necessary. Remaining discomfort after 
170 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 


the effects of the anesthetic wears off may be some¬ 
what reduced by sucking ice after the treatment and 
by applying cold neck compresses for about an hour. 

It is very important that prompt treatment be 
adopted at the first signs of laryngeal affection, for 
the safety of the local tissues and the voice, for the 
patient’s mental composure, and in order that these 
drastic and somewhat dangerous treatments may be 
avoided. If one has a case of pulmonary tubercu¬ 
losis it is well to have the larnyx examined occa¬ 
sionally, as it is possible for trouble to start in this 
region without much pain or soreness. By such 
examinations one may be able to nip in the bud any 
developing laryngeal involvement. The patient 
should not be continually thinking about the larnyx 
and wondering if it is all right, but should include 
the examinations simply as a part of his routine. 
Under proper general treatment it is very rare that 
other organs of the body will become involved. If 
the larnyx does become affected, remember the im¬ 
portance of abstinence from food and the use of 
sunlight, and do not neglect the proper use of the 
mind. 


INTESTINAL TUBERCULOSIS 
This is another quite serious tuberculous condi¬ 
tion. It seldom appears except in cases which have 
been improperly treated, especially in regard to 
diet. When it occurs before lung affection it will be 
found in those cases who have been on a very im¬ 
proper diet or where the intestines have been weak- 
171 


TUBERCULOSIS 


ened by an inflammation, such as that of typhoid 
fever. Of course, the typhoid fever itself would 
never have occurred if the diet had not been very 
unsatisfactory. In any case, when this form of 
tuberculosis develops, constant adaptation of treat¬ 
ment will be required for some time. 

As the fever generally is moderately high, rest is 
especially important. The same general plan is fol¬ 
lowed as already has been described, except that 
complete rest is continued somewhat longer. 

As for the diet, vegetable broth usually is pref¬ 
erable to the fruit juices, though if the latter have 
been producing no irritation in the regular diet they 
may be continued. Often it is well to take an abso¬ 
lute fast for about three days, then broth for two 
or more days. Another helpful drink is flaxseed 
tea, flavored with a little honey and lemon juice. 
The flavoring is kept at a minimum. A satisfac¬ 
tory schedule for the broth is a cup every two or 
three hours; but the flaxseed tea may be taken in 
half-cup doses whenever desired. If the diarrhea 
is severe and there is hemorrhage, the flaxseed tea 
should be used even when the broth is omitted. 

After the fast and broth or fruit diet the Salis¬ 
bury meat diet may be adopted with benefit for one 
to two weeks, the length of time depending upon 
the weight and strength of the patient and the prog¬ 
ress made. This diet consists of nothing but broiled 
scraped beef and hot water. Three meals a day 
are to be taken, each meal consisting, at the start, 
of four ounces and increasing two ounces per day 
172 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 


up to twelve ounces at each meal. A glass of hot 
water should be taken one hour before meals, and 
one a half hour before retiring. This quantity at 
each time is gradually increased to two glasses (one 
pint). The meat is prepared as follows: Lean 
round steak is secured, and whatever fat or connec¬ 
tive tissue is present is carefully removed. The 
flesh is then ground in a food chopper, formed into 
cakes, and broiled. A little salt may be used to 
flavor the meat, and a little lemon juice may be 
added after cooking if desired. After a few days 
a little grated garlic may be incorporated with the 
meat. Nothing but the meat and hot water is to be 
taken for at least a week, and if the weight and 
strength are satisfactory it may be continued for 
another week. A few pounds loss in weight may 
be expected. If the bowels do not evacuate enemas 
should be taken daily. 

The meat diet should be followed by the usual 
milk diet, preceding the milk diet with one day 
on acid fruits which should be well tolerated by that 
time. The usual plan of taking the milk is to be 
followed. If diarrhea occurs the quantity of milk 
must be somewhat limited. As soon as some weight 
has been gained the meat diet should be taken again 
for a week, preceding it by one day on nothing but 
hot water. In some cases diarrhea may be suffi¬ 
ciently corrected by employing gelatine in the milk. 
This is employed in the following manner: Take 
one tablespoonful of plain gelatine and soak for ten 
minutes in several ounces of cold milk. Then add 
173 


TUBERCULOSIS 


an equal amount of hot milk and stir until dis¬ 
solved. Add this to a quart of milk. Each quart 
used is to be treated in the same way. If this is not 
effective in controlling the diarrhea the milk may 
be made into junket. Sometimes dried milk, diluted 
with half the usual quantity of water, will be help¬ 
ful. In this case a smaller total quantity should 
be taken. As a rule it is not well to employ dates, as 
suggested for diarrhea developing in ordinary cases. 

These adaptations are not made with the idea 
of entirely checking the diarrhea. If it occurs it is 
because it is needed, and four or even five evacua¬ 
tions a day would not call for any change in the 
milk. In no case should drugs be taken to suppress 
the diarrhea. The diet suggested is important, and 
should be used if at all possible. If there is much 
gas when on the milk diet the milk may be taken in 
smaller quantities at more frequent intervals, or it 
may be diluted one-third with barley water, grad¬ 
ually returning to straight milk as the condition im¬ 
proves. If constipation should occur the usual 
enemas must be taken. It is hardly likely that any 
insurmountable difficulties with the milk will be ex¬ 
perienced when it is preceded by the meat diet and 
the proper general treatment is taken. 

A mixed solid food diet should not be employed 
except as a very last resort. The intestines are in¬ 
flamed, filled with mucus, and often ulcerated. Solid 
food is very prone to fermentation and putrefaction, 
with the production of large quantities of gas and 
consequent severe pain; also, it is irritating to the 
174 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 


inflamed intestinal surfaces. If the milk cannot be 
handled and the weight and strength will not permit 
further use of the exclusive meat diet, a diet of 
the broiled lean beef, together with fresh raw green 
vegetables, especially onions and garlic, but also let¬ 
tuce, spinach, tomato, and in some cases carrot, may 
be tried. Everything must be very thoroughly mas¬ 
ticated. The quantity of meat on this plan should 
not exceed eight ounces per meal. The hot water 
is to be taken as has been directed. Gradually other 
vegetables may be added as the condition improves, 
also toasted whole wheat bread (preferably oven- 
toasted) and boiled whole grain rice. 

The fast or broth or fruit diet should be repeated 
as often as the weight and strength will permit until 
the desired results have been secured. It is very 
necessary that the intestines be restored to a normal 
condition in order that food may be properly di¬ 
gested and assimilated and the necessary building 
materials furnished the body. Unless the intestines 
are in a condition to do this it will be useless to give 
any appreciable amount of food and the loss of 
weight occasioned by the frequent periods of ab¬ 
stinence should not be considered a detriment. 
Weight will be gained more quickly thereafter, and 
the general improvement in the whole condition will 
show the value of this treatment. It is the continual 
feeding in spite of the inflammation, and the use 
of drugs to check the diarrhea, which makes intesti¬ 
nal cases so serious under orthodox treatment. Pa¬ 
tients who already are much underweight and lack- 
175 


TUBERCULOSIS 


ing in strength can still take an occasional short 
fast; and in these cases the frequent or occasional 
use of the exclusive meat diet will be found very 
helpful. This has some of the advantages of the 
fast while at the same time it furnishes a little nour¬ 
ishment. Diet is sometimes quite a problem in in¬ 
testinal cases, but with the assistance of other appro¬ 
priate measures it should soon be solved. 

One of the most important of these other meas¬ 
ures is ultra-violet radiations. On account of the 
fever, which is usually present with greater persist¬ 
ence in these cases, the radiations are preferred to 
the natural sunlight, though the latter may be em¬ 
ployed if the former are unobtainable. In giving 
the radiations the lamp is centered over the abdo¬ 
men, but the entire body is exposed. The back also 
should be rayed, centering the lamp over the lum¬ 
bar region. A start is made with two-minute expo¬ 
sures, increasing one minute a day up to twenty or 
thirty minutes for each side of the body. The eyes 
should be protected with colored glasses. After 
three or four weeks’ treatment, five to seven days’ 
rest is observed and the treatments started again. 
The height of the lamp above the body should 
be 36 inches at the start, gradually lowering it to 
24 inches after the full length treatment has been 
reached. The exact height of the lamp and the 
rate at which the exposures are increased will de¬ 
pend upon the patient’s reactions, and the age and 
efficiency of the lamp. 

If necessary to employ natural sunlight, only the 
176 


LARYNGEAL AND INTESTINAL TUBERCULOSIS 


abdomen is exposed until the temperature is normal. 
Treatment must be started carefully and exposures 
lengthened gradually, the same as with the ultra¬ 
violet rays. A cool sponge bath should be applied 
to the parts after the treatment. The maximum 
exposures should be thirty minutes until fever has 
entirely subsided, after which as much as three 
hours may be taken, the entire body being gradually 
included. When taking over thirty-minute expo¬ 
sures the parts may be sponged with cool water 
every ten or fifteen minutes, depending upon the 
heat of the sun and the desires of the patient. All 
treatments should be concluded with a brief appli¬ 
cation of the cool water. It is seldom necessary to 
observe stated rest periods from sun baths, as there 
will be days when they cannot be obtained. If 
symptoms seem to be increased at any time, how¬ 
ever, the baths may be discontinued for two or three 
days. This is very unlikely to occur if the exposures 
are properly graduated. The head may be kept 
shaded if desired. This is advisable only for very 
weak patients or when the sunshine is very hot and 
direct. Usually the best times of the day for sun 
baths are mid-forenoon and mid-afternoon. 

Some cases may find it difficult to obtain either 
the sun baths or ultra-violet radiations. In these 
cases the cold abdominal pack may be used to great 
advantage. This consists of a muslin or linen cloth 
of several thicknesses, wide enough to cover the 
abdomen from the breast bone to the pubis, and 
long enough to go completely around the body and 
177 


TUBERCULOSIS 


overlap a few inches. This is wrung from cold 
water, quickly and snugly applied, and completely 
covered with a somewhat wider piece of woolen 
cloth of sufficient weight to prevent much evapora¬ 
tion (usually about three thicknesses). The whole 
may be covered with a waterproof cloth if such is 
available. This is preferable. The pack should re¬ 
main on for two hours or so. It usually is given 
in the afternoon, but in severe cases it may be ap¬ 
plied before retiring, also, and allowed to remain 
on all night. Upon its removal the abdomen should 
be bathed quickly with cold water, carefully dried, 
and covered well for warmth. After the fever has 
entirely subsided the abdominal pack need be ap¬ 
plied only once every other day for two weeks, then 
twice a week for as long as it seems to be produc¬ 
ing favorable effects. 

Enemas usually will be required while fasting or 
while taking broth or fruit, and perhaps especially 
while on the meat diet. They should be used while 
fasting, even if there is diarrhea. The enema water 
should be boiled and then cooled sufficiently for in¬ 
jection, but it should be taken as hot as can be com¬ 
fortably borne. Plain water usually is sufficient; 
but if the lower bowel also is affected, the juice of a 
lemon to each pint of water will be helpful. An 
infusion of garlic may be used, also. The high 
enema should not be employed if the large intes¬ 
tine is affected, and only if specially needed in other 
cases. While on the meat diet a pint of water will 
usually be enough for the enema. This quantity 
178 





LARYNGEAL AND INTESTINAL TUBERCULOSIS 


will be sufficient in most cases when on the milk diet. 
In either case, however, it may be necessary to re¬ 
peat the enema immediately after ejection of the 
first enema. The water should always be injected 
very gradually. 

There are no special exercises for this condition. 
When the genera] health warrants it, walking may 
be started and increased very gradually. 


179 


CHAPTER IX 

Treatment of Bone Tuberculosis 


T30NE tuberculosis usually occurs independently 
^ of a lung infection, and, therefore, admits of 
somewhat different treatment, especially in the 
lighter cases. However, the same fundamentals 
apply; and if the condition has progressed so far 
that there develops the characteristic general symp¬ 
toms of loss of weight and strength, fever, etc., the 
same general treatment as has been given for pul¬ 
monary cases should be used, with such modifications 
as will be described here. In advanced cases of bone 
tuberculosis the lungs may become affected, and fre¬ 
quently other organs as well, in which cases the gen¬ 
eral treatment is still more necessary. The severity 
of the case, however, does not vary the nature of the 
treatment so much as the duration of treatment. 
The essential factors of rest, proper food, air, sun¬ 
light, sleep, etc., are just as necessary in incipient 
cases as in the more advanced cases, but the latter 
will require a longer period of treatment. 

REST 

As usual we start with rest. The degree and 
duration depend, first, upon the general condition. 
If general symptoms are present or if other organs 
are affected, the same plan of rest will need to be 
followed as for chronic pulmonary cases. If the 
condition is just starting and there are no general 
180 


TREATMENT OF BONE TUBERCULOSIS 

symptoms, rest in bed may not be necessary, but 
plenty of sleep should be secured. If the shaft of 
the bone is affected anywhere but in a leg, walking 
will be permitted, and complete rest need be ob¬ 
served only for the affected parts. If the legs are 
affected, and especially if the hip joint is involved, 
bed rest for a few weeks will be necessary even in 
the lighter cases; and in severe cases of this kind 
protracted rest may be required. In the lighter 
spinal cases walking may be permitted; but this will 
depend upon whether or not it causes pain. If there 
is a disinclination to walk, even these light cases had 
better rest for a few weeks. In all but the lightest 
spinal cases rest is very necessary. And if the cer¬ 
vical spine is affected rest is imperative. In these 
cases the strain of activity will bring about greater 
deformity, with correspondingly greater danger of 
causing spinal cord pressure and paralysis. When 
the cervical spine is affected to any considerable ex¬ 
tent such activity may cause death. 

There are various methods of enforcing rest. If 
an arm is affected the part may be carried in a sling. 
If the legs or hip joints are affected rest in bed will 
be required, though usually only one hip joint is 
diseased. If sunlight can be secured it usually is not 
necessary to use any brace on the leg. If the envi¬ 
ronment is not ideal, traction (stretching) often will 
be helpful—a special traction splint being best to 
use for this. In these cases when the diseased part 
is protected from injury by immobilization, the up- 
181 


TUBERCULOSIS 

per body may be given a certain amount of exercise, 
and deep breathing may be practised. When the 
spine is affected to any marked extent rest in bed will 
be indicated; and in severe cases or if the environ¬ 
ment is not ideal, a plaster jacket or a brace of 
some kind may be required. When the cervical spine 
is affected it generally is best to recline on the back, 
with sandbags on each side of the neck to hold the 
head stationary and a small bag beneath the neck to 
support the spine. 

All splints, braces, etc., should be avoided as far 
as possible. When the proper general treatment is 
used, especially sun baths, it usually is possible to get 
along without such artificial assistances. Any un¬ 
toward movements which the patient might make, 
even while in bed, will be checked by pain—Nature’s 
danger signal. Yet there will be cases where im¬ 
mobilization will be necessary, especially to prevent 
injury by movements during sleep, and to permit 
relaxation for sleep without fear of injury. 

The length of time necessary to observe rest of 
the affected parts, of course will vary with the se¬ 
verity of the disease and the reactive power of the 
patient. As a rule it is well to observe rest until 
healing is complete, which will be indicated by the 
disappearance of symptoms. If general symptoms 
are present these probably will disappear before the 
local symptoms; but rest of the affected parts must 
be continued until the latter, also, have been over¬ 
come. 

182 


TREATMENT OF BONE TUBERCULOSIS 


DIET 

Diet is the same as for chronic pulmonary cases, 
especially if there are general symptoms. With due 
allowance for age, the fruit diet usually can be con¬ 
tinued somewhat longer than in lung cases—perhaps 
about one-third longer. The extra cleansing which 
this diet permits and assists in securing will do much 
to reduce the local inflammation and prevent or les¬ 
sen abscess formation. Regular repetitions of the 
fruit diet, which may be taken every month, may be 
extended a day or so each time. The milk diet is 
especially important in bone cases, because of the 
large amount of calcium which milk contains. Cal¬ 
cium always favors all healing, especially healing of 
bones. It is very necessary for bones, as they are 
largely composed of it. It is very seldom that any 
circumstances will arise to make the milk diet im¬ 
possible, particularly since most of the patients will 
be children. However, if a solid food diet should 
be required it should include large amounts of the 
foods containing the most calcium—string beans, 
kidney beans, carrots, cauliflower, oranges, peaches, 
figs, berries, onions, and greens of all kinds. Of 
course, milk, buttermilk, and cheese are included 
even in the solid food diet. Eggs, beechnuts, Brazil 
nuts, and figs also are valuable; but, being concen¬ 
trated foods, they must be used in moderation. Par¬ 
ticular care always should be taken to provide an 
abundance of raw foods. These yield much more 
183 


TUBERCULOSIS 


of the necessary elements and vitamins per ounce 
or per meal than cooked foods. 

FRESH AIR 

It is fortunate that in most bone cases deep 
breathing may be practised regularly, unless the 
lungs also are affected. Fresh air is of the greatest 
value when large quantities of it can be drawn into 
the lungs. As has been explained, some care is nec¬ 
essary in lung cases; but when only the bones are 
affected good deep breaths can be taken as desired, 
and should be taken every hour. The same plan of 
holding the breath for short periods should be ob¬ 
served as suggested for lung cases. Conscious deep 
breathing can be practised as much as the patient 
desires, merely stopping short of dizziness. A little 
giddiness may be felt when first starting deep breath¬ 
ing; but by increasing the amount of breathing grad¬ 
ually it will cause no trouble. 

Do not forget that the skin also requires air. If 
sun baths are taken as suggested in the next para¬ 
graph considerable air, naturally, will reach the skin. 
Whenever the weather permits, air baths in addi¬ 
tion to those obtained while taking the sun bath 
may be taken to advantage. 

SUNLIGHT 

The reader should have the conviction by this 
time that sunlight is one of the most powerful aids 
in restoring tuberculous patients to health. In bone 
cases it is especially important; and, fortunately, it 
184 



185 


Tuberculous children taking the fresh air and natural sun bath at a hospital on the shores of the Medi¬ 
terranean sea. This locality is famous for the brilliance of its sunlight and the children are being given 

the full advantage of it. Note how they are tanned. 






















TUBERCULOSIS 


can be used freely in these cases, since fever gener¬ 
ally is slight or absent. General exposures should 
be used, following the same plan as has been de¬ 
scribed for lung cases. If the patient should be so 
unfortunate as not to be able to expose the entire 
body, the affected parts at least should be given the 
benefit of the sun. The natural sunlight is superior 
to the ultra-violet rays for these cases, but the latter 
are very good when the sun cannot be obtained. 
One trouble in using the sun baths is that the rays 
may be rather frequently obscured by clouds. On 
cloudy days the ultra-violet lamps will prove a valu¬ 
able adjunct. 

The use of sunlight in tuberculosis, and especially 
when the bones, skin and glands are affected, re¬ 
ceived its chief impetus from the work of Dr. 
Rollier. And through his work the medical doctors 
were brought to look more favorably upon other 
natural methods of treatment. Dr. Rollier founded 
a sanitarium in Leysin, Switzerland, which has be¬ 
come famous all over the world. Sun baths are a 
very prominent, in fact, the leading factor of treat¬ 
ment at this sanitarium. The sunlight is very bright 
and effective in the mountains of Switzerland, and 
even though the air is cold in the winter the sun is 
so warm that the sun baths are continued the year 
round. The skin naturally becomes much more 
active under continued exposure, and will be much 
more efficient in resisting cold. While Dr. Rollier 
places his chief reliance upon the sunlight, he is also 
very sensible regarding diet and other health-restor- 
186 


TREATMENT OF BONE TUBERCULOSIS 


ing measures. He does not believe in overfeeding, 
but gives just enough to maintain weight and 
strength. The amount required for these purposes 
will be found to be less when taking the sun baths 
than at other times. Less fuel food is used because 
light, heat, and energy are obtained from the sun. 
When resting, very little protein food will be re¬ 
quired. All foods will be better utilized under the 
influence of sunlight, as has been proven in the treat¬ 
ment of rickets and in observing the remarkable ef¬ 
fects of ultra-violet radiations upon animals fed on 
a deficient diet. Dr. Rollier does not even use cod- 
liver oil, a favorite prescription with most doctors. 
I wish to add, however, that I have no objections 
to using cod-liver oil. It is an excellent additional 
means of securing valuable vitamins. 

The effects of the sun are so wonderful in promot¬ 
ing health that braces are not used, even in spinal 
cases. This is a great advantage in joint cases, as 
there is less tendency to complete ankylosis. It also 
has been found that the sunlight and proper diet 
keep the muscles firm even without exercise. Con¬ 
sequently, there is no weakening effect from the en¬ 
forced rest. Altogether, the sun deserves credit for 
doing much of the healing work. 

Dr. Rollier’s method of giving the sun baths is as 
follows: On the first day he exposes the feet for 
five minutes at a time two or three times a day. 
On the next day he exposes them ten minutes, then 
fifteen, and so on, increasing five minutes a day. On 
the second day he also exposes the legs for five min- 
187 


TUBERCULOSIS 


utes and then increases five minutes a day. Thus 
on the second day the feet are uncovered for five 
minutes and then the legs for five minutes, making 
a total of ten minutes for the feet. On the third 
day the abdomen is included in the same manner. 
On this day the feet will be exposed for fifteen min¬ 
utes, the legs ten minutes, and the abdomen five min¬ 
utes. The rest of the body is then added in the 
same manner, so that at the end of two weeks gen¬ 
eral exposures are being given for thirty to forty- 
five minutes. This is gradually increased to from 
three to six hours. A good coat of tan usually is a 
favorable indication of healing. This is an excel¬ 
lent plan for anyone to follow in taking sun baths. 

WATER 

Use this element of Nature as has been directed. 
When on the milk diet little or no water will be 
required for drinking purposes. Enemas are to be 
taken as necessary. 

There is no necessity for using special compresses 
or packs so long as the sun baths can be secured. 
If unable to obtain either these or the ultra-violet 
radiations, cold packs will be found helpful in reduc¬ 
ing inflammation. These are applied in the same 
manner as the cold neck pack for laryngeal cases 
and the cold abdominal pack for intestinal cases, ex¬ 
cept that the cloths are cut to fit the part affected. 
If a hip is affected it is well to pass the pack com¬ 
pletely around the body, using the regular hip packs. 
In spinal cases the cloths (at least six or eight inches 
188 


TREATMENT OF BONE TUBERCULOSIS 

wide) are laid over the part and secured with a 
bandage about the body. Alternate hot and cold 
spinal compresses are helpful in these cases, the hot 
being applied for three minutes and the cold for one 
minute, making several changes. It is better to fol¬ 
low these alternate compresses with a cold wet cloth 
covered with flannel, with or without an impervious 
material, this “heating compress” to be left on for 
at least two hours. Hot compresses alone or a hot 
water bag may be used for fifteen minutes at any 
time for the relief of pain, though some may get 
more relief from the application of cold. The lat¬ 
ter should not be continued more than eight to ten 
minutes. 

When healing has resulted, exercise should be 
started. If one has an attendant to assist it is well 
to start with passive exercise; that is, the operator 
moves the part in all possible directions the same 
as though the patient were actively exercising it. 
This should be followed by massage. When mo¬ 
bility has been improved, active exercise may be 
started, increasing cautiously and gradually. If 
ankylosis has occurred, naturally a restoration of 
normal mobility cannot be expected, and no attempt 
should be made to break the ankylosis. Simply carry 
each movement as far as possible. There will be 
some improvement beyond the first very limited 
motion. Often there will be a false ankylosis due 
to long inactivity of the joint and to induration or 
other condition besides direct union of the diseased 
surfaces of bones forming the joint. In these cases 
189 


TUBERCULOSIS 


full mobility of the joint may be recovered if there 
is no true, bony ankylosis. 

EXERCISE 

The exercises which may be taken in cases of bone 
tuberculosis will depend upon the parts which are 
involved. Walking, as in most cases of tuberculosis, 
is the best of all exercises, and is to be employed 
whenever possible. Unfortunately, the hip, knee, or 
ankle is very frequently affected, and many spinal 
cases are not diagnosed until they are fairly well ad¬ 
vanced; hence walking can be used only in a limited 
number of cases. But if the lower extremities can¬ 
not be used the upper ones can be, unless the spine 
is badly involved. Even a small amount of exercise 
will help to keep the circulation more active and 
the digestion and elimination better. It also helps 
to occupy the patient’s mind. 

If the arms and spine are sound there may be 
used such movements as flexing and extending the 
arms, rotating the arms, swinging the arms in cir¬ 
cles, shrugging the shoulders, drawing the shoulders 
forward and pulling them backward, bending the 
head in all directions, and tensing the muscles along 
the spine. Even if the patient is confined to bed in 
a reclining position most of these exercises will still 
be possible. 

If only one arm or one shoulder joint is affected, 
the part may be held stationary with bandages while 
taking general exercise, including body bending 
movements, raising and lowering the legs, flexing 
190 


TREATMENT OF BONE TUBERCULOSIS 


and extending the legs, the full knee bend, etc.; also 
movements in a reclining position, such as raising 
and lowering the legs, flexing and extending the legs, 
sitting up and down, etc., could be used. 

In all spinal cases, even the mild ones, it usually 
is advisable to observe complete rest for a few weeks 
at least, after which walking is the only exercise 
that should be used until healing has been brought 
about. In severe cases complete rest must be ob¬ 
served until healing has resulted. 

Whatever the exercise used, it should be taken 
only once a day, starting with an amount that is easy 
to perform and increasing gradually. Usually three 
repetitions of each movement are sufficient at the 
start, the number gradually increasing to eight or 
ten. Rest from exercise should be observed two 
days a week (not together) for four to six weeks, 
and always one day a week. Any movements which 
cause pain should be avoided. There should be a 
period of complete rest for half an hour or so after 
each exercise period. 

The medical plan of enforcing rest for a consid¬ 
erable time after healing has resulted is unnecessary 
when natural methods have been used, for the rea¬ 
son that by the time healing has occurred the body 
has been cleansed of the toxins furnishing food for 
the germs, and sufficient vitality and resistance have 
been developed to prevent any new germs from 
gaining a foothold. Under orthodox treatment the 
local part may apparently heal even while the body 
is still toxic and the vitality only partly raised. 

191 


TUBERCULOSIS 


When genuine healing and strengthening of the en¬ 
tire body has been brought about by proper treat¬ 
ment, the only precautions to be observed are those 
covered in Chapter XIII on “After-Care.” Of 
course there always is gradual increase in amount of 
exercise. 


SURGERY 

In cases where there is much abscess formation 
there occasionally may be a legitimate use for sur¬ 
gery, especially in spinal cases where the pressure 
of the abscess often causes paralysis, and in all cases 
where the abscess shows a tendency to burrow to 
great distances. Incision of the abscess so as to 
allow free draining is the usual procedure. Further 
cutting should be avoided if at all possible. All 
aseptic precautions should be rigidly observed. 

It is well to understand, however, that such op¬ 
erations are attended with considerable danger of 
further infection even when great care is observed, 
and for this reason if for no other the use of the 
knife should be avoided whenever possible. Gen¬ 
erally it is only the neglected cases which will require 
such assistance. If properly treated from the start 
there will be little abscess formation, and this will 
be absorbed as the condition improves. In more 
severe cases natural drainage through sinuses will 
be brought about, and after healing the sinuses will 
close. Many times even in the severe and neg¬ 
lected cases a few weeks’ strict attention to rest, 
sun baths, and proper diet, including a fruit diet, 
192 


TREATMENT OF BONE TUBERCULOSIS 


will render an operation unnecessary. Strictly nat¬ 
ural methods should always be given a fair trial 
first, since they will be needed, anyhow. Most bone 
cases are among children, and the young generally 
respond very readily to rational treatment. 

In healed cases where there is ankylosis with con¬ 
siderable deformity, operations are often used to 
overcome the malposition; but this practise is gen¬ 
erally to be condemned. In spinal cases it should 
never be employed. In hip cases it may occasionally 
be used if the deformity is extreme and there seems 
to be a good chance of overcoming it. Mobility of 
the joint cannot, of course, be restored. No opera¬ 
tion should be considered unless the patient is fully 
recovered and in the best of health. If the deformity 
is not great one should leave well enough alone. 

MENTAL ATTITUDE 

A patient, hopeful, confident mental attitude is 
as important in these cases as in chronic lung cases. 
Considerable time usually is required for healing; 
and in the spinal cases, particularly, it may be neces¬ 
sary for the patient to lie a long time in one posi¬ 
tion, which is both tiresome and discouraging. The 
fact that most of these patients are children is a 
fortunate thing, because children naturally have 
more faith and optimism than adults. If they are 
handled correctly they will readily understand the 
necessity for keeping cheerful and avoiding temper 
and will be an example to their elders. Love is the 
keynote in handling children as well as others. 

193 


CHAPTER X 


Treatment of Tuberculosis of the Skin 


and Glands 


HERE is such similarity in the treatment of 



A tuberculosis of the skin and of tuberculosis 
of the glands that they will be considered together in 
this chapter. 

Skin cases, as a rule, are independent of lung 
infection and it is rare that there are any general 
symptoms. The condition seems to be local; but 
when one understands the true nature of tuberculosis 
it is easy to see that the real disease is constitutional, 
only the manifestation being local. However, the 
localization of manifestation permits the use of ex¬ 
ercise, deep breathing, etc., which often may have 
to be omitted for a time in lung and other cases. 

The gland cases considered in this chapter are 
those where only a few glands are affected, the con¬ 
dition apparently being local, as in skin cases. 
Usually only the glands of the neck, armpit, or 
chest are affected. Sometimes one or both testicles 
or one or both kidneys may become tuberculous. 
Severe cases of this kind may exhibit general symp¬ 
toms; but as a rule the symptoms are sufficiently 
localized to permit of liberal treatment. 


TUBERCULOSIS OF THE SKIN AND GLANDS 


Of course, in lung cases and often in other cases 
the lymph glands may be affected to some extent, 
either locally or generally. However, in these cases 
the glandular manifestations may be considered a 
complication of the major trouble, and treatment 
for the latter will take care of the glands. A more 
generalized glandular infection without lung infec¬ 
tion, as appears in scrofula, is to be treated the same 
as a chronic lung case, since it exhibits much the 
same symptoms—though such added exercise and 
deep breathing as the condition will permit should 
be used, also. The same applies to tabes mesen- 
terica, mentioned in the chapter on symptoms of 
tuberculosis. In tuberculosis of the kidneys rest 
usually is advisable until there has been definite well 
established improvement. 

Since skin and gland cases are more common 
among children, it would be well to give attention 
to the chapter on treatment of children, as well as 
to the chapter on treatment of chronic lung cases, 
and this chapter. 

SKIN TUBERCULOSIS 

In these cases complete or even partial bed rest 
is not necessary. Of course, plenty of sleep should 
be secured; but even a well person should see to- 
that. As recovery from tuberculosis is largely de¬ 
pendent upon an increase in vitality, the patient with 
a skin case has the advantage of being able to use 
two very helpful agents—exercise and deep- 
breathing. 


195 


TUBERCULOSIS 


If unaccustomed to exercise it must, of course, 
be started carefully and increased gradually. There 
are no movements which will have a specific effect 
in overcoming the trouble, but general exercises 
should be employed for their constitutional benefit. 
All. the larger groups of muscles should be used 
at each exercise period. Very satisfactory exer¬ 
cises will be free-hand calisthenics, such as bending 
the; head in all directions, raising and lowering the 
shoulders, circling the shoulders, swinging the arms 
in all directions, bending and twisting the body, 
raising and lowering the legs, the full knee bend, etc. 
At first there should be an amount that is easy to 
perform, and this is increased gradually. Once per 
day, six days a week, usually will be sufficient, as 
some daily walking should be employed, also. Walk¬ 
ing is always excellent. As much as ten miles a 
day may be taken if there is time for it, though, of 
course, this distance must be approached gradually. 

Deep breathing should be combined with the 
walking, and also used before and after the general 
exercise periods and for a few minutes whenever 
convenient during the day. 

As to diet, this should consist, as usual, of the 
fast or fruit diet followed by the milk and fruit diet. 
In most cases the acid fruit diet is to be preferred 
to the absolute fast, and this may be continued as 
long as ten days if the weight and strength will per¬ 
mit. This duration usually is possible, as the gen¬ 
eral health is not affected to any great extent except 
in the more advanced cases. The longer fruit diet 
196 


TUBERCULOSIS OF THE SKIN AND GLANDS 



will permit more thorough cleansing, and the met¬ 
abolism will be more strongly accelerated thereafter. 
The milk diet should follow the fruit diet, the same 
as in chronic lung cases, observing two or three days 
on the fruit every month. The milk diet is much 
the best of all diets, and every effort should be made 


General radiation with a mercury-quartz ultra-violet ray lamp. 
A good substitute for the natural sun bath. Indicated especially 
when there is fever as the lamp gives little heat. 

to take it. If unable to do so the raw food diet 
of fruits, vegetables and nuts is next best. 

As in bone cases, the sun baths or the substitute 
ultra-violet radiations are of supreme importance. 
General sun baths should always be used; but if pos¬ 
sible to employ, in addition, concentrated rays on 
the specific lesions, this treatment will be of further 
assistance. A quartz lens is the best for concen¬ 
trating the sunlight, since it allows the ultra-violet 
197 








TUBERCULOSIS 


rays to pass through the skin. But some benefit will 
be secured through ordinary glass if necessary to 
use this. The rays must be concentrated to a point 
about the size of a dime, this spot to be kept moving 
over the lesion just rapidly enough to prevent burn¬ 
ing. Where the lesion is small, making impossible 
much moving about, the distance of the lens from 
the skin may be slowly but constantly increased and 
decreased so as to vary the concentration of the 
rays and thus prevent burning. A mild burn will 
do no harm and may be of some assistance; but as 
a rule it is best to come just to the point of burning 
and then shift the concentration. This local appli¬ 
cation of the rays, as with general exposures, must 
begin cautiously and increase gradually. In most 
cases a one-minute application will be sufficient for 
the first day. This should be increased one minute 
at a time (daily) up to ten-minute exposures. The 
local treatment may be taken while in the gen¬ 
eral sun bath. Cool baths should follow each 
general sun bath, as has been advised. 

If unable to secure the natural sun baths the ultra¬ 
violet radiations, both local and general, will be 
found of much assistance if these are procurable. 
The general radiations should be given as previously 
described, but the application of the local treatment 
will vary in individual conditions. A special lamp 
is required for the local treatment, using quartz 
lenses; and, since the technique is rather compli¬ 
cated, the treatments should be given by a qualified 
medical or drugless doctor. Sometimes the lamp 
198 


TUBERCULOSIS OF THE SKIN AND GLANDS 

may be held an inch or so from the skin, and in 
other cases actual pressure upon the skin may be 
employed. The length of the exposure depends 
upon the distance of the lamp from the skin, the 
reaction of the patient, and the degree of erythema 
(congestion) desired. Frequently a slight burning 
is beneficial. It usually is well to rest from the 
general radiations for a week after every four weeks’ 
treatment. The application of the cool bath is not 
so necessary after these treatments, but may be em¬ 
ployed to advantage, since it should be used some¬ 
time during the day, anyhow. 

There will be few cases who cannot secure at 
least some sun baths or ultra-violet radiations, and 
all that can be should be secured. For those who 
find it difficult to obtain these light treatments the 
use of water will be helpful. Steam baths usually 
are very good. They should not be taken while on 
a fruit diet, but at other times they may be used 
twice a week. There are several forms of cabinets 
for taking these baths; but if the patient is suffi¬ 
ciently vigorous it will be best to use the kind which 
includes the head, especially when some of the le¬ 
sions are on the face. Care must be observed not to 
overdo the steam baths. They should be continued 
just long enough to induce free perspiration. This 
may be anywhere from ten to twenty minutes. A 
cold wet towel should be wrapped round the head 
during the treatment. Afterward the perspiration 
should be rinsed off in a warm shower, and the 
treatment terminated by a cold shower. 

199 


TUBERCULOSIS 


For those who do not have the facilities for tak¬ 
ing a steam bath the wet sheet pack will be valuable. 
This may be taken twice a week, and should be fol¬ 
lowed by a rinsing warm bath and a cold bath— 
by shower, spray, bucket pour, sponge, or cloth. The 
method of applying the pack is as follows: Sev¬ 
eral blankets are placed on a bed, preferably. Then 
a sheet which has been wrung from cold water is 
laid over the blankets, and the patient lies down 
quickly upon this. Then an assistant at one side 
rapidly brings the near side of the sheet over the 
near arm and the body and the near leg, tucking it in 
well; then the far side of the sheet is brought all the 
way over and tucked in along the outer edge of the 
near side of the body. It also is folded snugly about 
the neck and turned up over the feet. The patient is 
then wrapped closely in the blankets. When this 
pack is properly applied the patient becomes warm 
within two or three minutes and will perspire within 
an hour or less. Usually the patient remains in the 
pack for two hours. If the reaction is poor, hot 
water bottles may be placed alongside the body and 
at the feet until warmth is restored. A cold wet 
towel should be kept wrapped around the head. The 
patient may sleep while in the pack if he desires. 
This is a very powerful eliminator, and is of much 
assistance in removing some of the soil upon which 
the germs feed, also in increasing the activity and 
resistance of the skin itself. It is not equal to the 
sun bath, but will be of much value where this can¬ 
not be obtained. 


200 


TUBERCULOSIS OF THE SKIN AND GLANDS 


Dry friction baths and general cool baths should 
be taken in all cases. In administering the friction 
the affected skin areas should be avoided. One cool 
bath a day is sufficient unless taking more than one 
sun bath a day or except when the weather is un¬ 
usually warm. 

Various special treatments are sometimes em¬ 
ployed for the skin lesions, all of which have for 
their purpose the sterilization or destruction of the 
tubercles. For this purpose applications of zinc 
chlorid, pyrogallic acid, or silver nitrate are often 
used, or the actual cautery with the electric current. 
Some doctors employ the knife to scrape the parts. 
None of these methods is equal to sunlight; and 
since the advent of the water-cooled ultra-violet 
lamp by which local radiations may be given, even 
the medical doctors are abandoning these other local 
measures. In no case are such local applications 
curative, as they do nothing to remove the causes. 
Never forget to give chief attention to the constitu¬ 
tional treatment. 

In considering the latter let us not forget the 
use of the mind. Put the mind into every effort 
made for improving the health, and better results 
will be secured. One factor which some skin cases 
have to contend with is the self-consciousness and 
humiliation which is produced by the appearance 
of lesions upon the face. This should not be al¬ 
lowed to interfere with progress through giving rise 
to despondency, fear, self-pity, etc. Neither should 
it prevent the patient from being out of doors in the 
201 


TUBERCULOSIS 


fresh air and sunlight as much as possible. The 
thing to do is to keep so busy with constructive 
thoughts and actions that there is no time for the 
mind to dwell upon personal shortcomings. Realize 
that the lesions are there for a purpose, and the 
sooner the causes are removed by right living and 
right thinking the sooner will the disfiguring spots 
be removed. 

GLAND TUBERCULOSIS 

The treatment for localized gland cases will be 
found to follow closely that employed in skin cases. 
Usually, rest is unnecessary, and exercise and deep 
breathing can be taken the same as in a case of skin 
infection. In the more severe cases, which have 
been neglected and where there is considerable sup¬ 
puration with the production of general symptoms, 
rest for a few weeks may be required. This applies 
also to tuberculosis of the kidney and of the testicle, 
which latter often causes considerable pain. In some 
of these testicular cases a supporter may be suffi¬ 
cient, but in the more severe cases rest in bed is ad¬ 
visable until there has been definite improvement. 

In any case, no violent exercise should be taken. 
Walking, deep breathing, and free-hand calisthenics, 
as described in the first part of this chapter, will be 
sufficient. In testicular cases walking may have to be 
limited even if the patient is able to be up and 
around. Moderate exercise in a reclining position, 
however, would be possible and safe in these cases. 
Deep breathing of fresh air is always particularly 
202 


TUBERCULOSIS OF THE SKIN AND GLANDS 

important. There is nothing like air and sunlight 
for any case of tuberculosis. 

In regard to sunlight, the general and local radia¬ 
tions should be used as in skin cases. The rays are 
concentrated upon the affected glands or upon any 
sinuses which may have formed. The local ultra¬ 
violet radiations are especially good for treating 
sinuses. Any accumulated pus should be evacuated 
by squeezing or, preferably, by sterile cotton swabs, 
before applying the lamp. Discharging sinuses will 
have to be kept dressed with a bit of absorbent cot¬ 
ton and gauze held in place with adhesive plaster. 
The dressings must be removed when taking a sun 
bath or air bath. As much time as possible should 
be spent in the air bath, even if sun baths are neces¬ 
sarily limited. In tuberculosis of the testicle sun¬ 
light or ultra-violet radiations will do much to save 
a gland that otherwise might be destroyed. 

If unable to secure either of these light treat¬ 
ments, cold packs should be used. These are ap¬ 
plied to the testicle the same as the cold neck pack 
is in laryngeal cases or the cold hip pack in hip 
joint cases, using cloths between the thighs sup¬ 
ported front and back (at least front) by a waist 
band. The pack may be applied once during the 
day for one to two hours and again upon retiring 
at night, when it may remain all night or until dry. 
Upon its removal the covered parts should be bathed 
with cold water, then carefully dried. If there are 
no open sinuses the mud pack is of value. Sterilized 
clay should be employed, wetting it in cold water and 
203 


TUBERCULOSIS 


thoroughly coating the affected parts. The clay 
may be bound on with .gauze bandages. The length 
of application is the same as for the cold pack. 

Due attention must be given to the diet. The 
initial fruit diet may be lengthened to ten days if 
possible, the same as in the skin cases. The milk 
diet is just as important as all other cases. If neces¬ 
sary to use a solid food diet care should be observed 
to drink plenty of water between meals; eight glasses 
a day will be none too much. 

The favorite medical treatment for tuberculous 
glands is an operation for their removal. In cases 
which are just starting, where only two or three 
small glands are affected, this may seem to be of 
benefit; but since it does nothing to remove the 
causes of the trouble other glands are quite certain 
to be affected later on. Then there is always the 
danger of spreading the infection by the cutting, 
since the body is in a condition to tolerate further 
infection. Such operations should be avoided in 
practically all cases. Today many surgeons are 
using ultra-violet radiations instead of the knife. 

Persistent treatment is required in gland cases, as 
well as in others, especially if the disease has been 
allowed to progress to the point of suppuration. 
However, it will be well worth while, and the pa¬ 
tient should be ready and willing to do his best with 
patience, hope, and confidence. 


204 


CHAPTER XI 
Treatment of Children 


/CHILDREN differ from adults in a number of 
ways that are not apparent to the casual ob¬ 
server. It is not merely that they are smaller in 
size, but their bodies and minds work in a some¬ 
what different manner. In treating children, there¬ 
fore, it is not sufficient merely to reduce the quantity 
of food or to shorten the length of a treatment. It 
is necessary to adapt the measures employed to all 
the characteristics of childhood. 

First of all it should be remembered that the 
child’s body is operating at a higher rate of speed, 
both organically and muscularly. The breaking 
down and building up of tissues goes on more 
rapidly; but always the building up must exceed the 
breaking down if growth is to take place. This re¬ 
quires more rest, and more food in proportion to 
the size and weight of the child than for an adult; 
and on account of the smallness of the organs, more 
frequent and constant feeding is needed. Do not 
get the idea, however, that children cannot fast, be¬ 
cause they often do it better than adults. But the 
length of the period of abstinence must be regulated, 
avoiding fasting any longer than is really necessary. 
The child has less resistance than the adult be- 
205 


TUBERCULOSIS 


cause it has not yet had time to develop much. 
Therefore it must receive greater protection from 
the elements, and from contamination by internal 
or external filth. In spite of this lack of resistance, 
however, the vitality of the child is high; and, while 
it will become sick quickly, it will also get well 
quickly as soon as the habits of living and the en- 



Sun baths in the winter time showing how the body may be 
inured to exposure. The child on the left is a spinal case and 
is wearing a brace so that he can get around. 

vironment have been corrected. One should not get 
the idea that children are very fragile and must be 
handled “with gloves,” as it were. Their high vi¬ 
tality renders them quite resistant to the ordinary 
things in their environment. It is only the unusual 
to which they are likely to succumb. Create the 
proper environment for the children and instill right 
habits of living into their minds from the time of 
birth, and they will have the maximum vitality and 
206 










TREATMENT OF CHILDREN 


resistance, which will be amply sufficient to protect 
them against tuberculosis or other diseases. 

The treatment of children is simplified to a con¬ 
siderable extent by the fact that the mental processes 
do not so frequently enter in as causes of disease; 
nor has there been time for the formation of destruc¬ 
tive mental habits which will interfere with progress. 
The psychology of the child is important and should 
be given attention, but it seldom presents the prob¬ 
lem that is often encountered in treating adults. 
Children are very open to suggestion and can be 
trained readily in the right paths. 

Of course, children are similar to adults in many 
ways even though they are different in some other 
ways, and the same fundamentals of treatment 
always apply. The greatest modification of treat¬ 
ment will be required before the age of two years, 
but it is rare that a child so young will be afflicted 
with a form of tuberculosis. After the age of four¬ 
teen most children can be treated the same as adults. 
It is the period between those ages that will require 
the most attention. 

As far as rest is concerned the same plan as for 
adults may be employed. Everyone knows that a 
child requires more sleep than an adult; but the 
resting plan will give plenty of opportunity for this. 
While the adult will be merely resting, the child will 
be sleeping. Children are more inclined to be active, 
however, and greater restraint may be necessary 
for a time. The instincts of children usually can be 
trusted to guide their activities. But when the body 
207 


TUBERCULOSIS 


has become diseased so that the instincts are pre¬ 
vented from fully manifesting, the reasoning 
guidance of the adult will be required. When there 
is a very definite desire to be active or to rest, how¬ 
ever, it usually will be safe to agree, even though 
reason may speak to the contrary. We cannot 
always determine accurately just what is going on in 
the child body, and it is well to remain open to sug¬ 
gestions from the child’s instincts. Not often will 
any conflict arise, and if one follows the general 
plan already given, using plain common sense, there 
is little likelihood of any difficulty arising. 

It is in the matter of diet that the greatest modifi¬ 
cation of treatment will be required. The necessity 
for frequent replenishment of the supplies of energy- 
yielding and tissue-building foods preclude long 
fasts. In most cases fasting should not be used at 
all, the fruit diet being preferable. The length of 
the fruit diet will depend upon the age, weight, and 
general condition. For acute cases five days usually 
will be sufficient, though some cases which are much 
run down will not be able to take this diet for more 
than three days. These periods can be repeated, 
if necessary, after from two to four weeks. Rarely 
will it be advisable to continue this limited diet as 
long as seven days at once, and never except in the 
case of children approaching the age at which adult 
treatment may be used. For chronic cases three 
days on fruit usually will be sufficient, repeating it 
after two weeks if fever persists. The regular 
repetitions taken every month should be for one or 
208 


TREATMENT OF CHILDREN 

two' days. Quite young children have fasted, or 
very nearly so, for as much as a week, especially in 
acute diseases; but in dealing with tuberculosis it is 
well to compromise between the cleansing and build¬ 
ing processes and to feed whenever the condition is 
reasonably satisfactory, always being careful to use 
a strict diet.. 

For this diet, milk again becomes the main 
standby. It is naturally the diet of childhood, and 
it is infrequent that any difficulty will be experienced 
in using it. It may prove a little monotonous for 
children who have been used to eating a variety of 
solid foods; but since fruit is used with the milk, 
by varying the kind of fruit, sufficient change may 
be secured. Milk so adequately nourishes the body 
that, in most cases, even among adults there is not 
the desire for other foods. In any case, monotonous 
or not, the milk diet should be used if the liquid can 
possibly be secured. There are few cases where 
milk of some kind cannot be obtained. It is now 
possible to get whole milk in the dried form; and, 
while this is not equal to the fresh milk, it will often 
be satisfactory for children when plenty of fruit is 
used, especially if the sun baths are taken regularly. 
Condensed milk never should be used, and evapo¬ 
rated milk rarely is satisfactory. In cases of neces¬ 
sity it would be worth the trouble to buy and keep 
a cow or some goats, rather than to do without 
milk. In those localities where goat’s milk can be 
obtained this should be used in preference to cow’s 
milk, as it is easier for children to digest. 

209 


TUBERCULOSIS 


Naturally, the quantity of milk that a child will 
require will be less than for an adult. The follow¬ 
ing table gives the maximum quantities for the full 
milk diet at different ages: 


PER DAY 

3 pints 

i/4 to 3 quarts 
2^4 to 3^4 quarts 


AGE 


i year or so 
i to 5 years 
<5 to 8 years 
8 to 13 years 
13 to 16 years 


3 to 4 quarts 

4 to 5 quarts 


The quantity taken on the first day after the fruit 
diet will depend not only upon the length of this 
diet but upon the age of the patient. The same pro¬ 
portion to total quantity should be used as in the 
case of an adult. For instance, if an adult who will 
take six quarts of milk per day starts with a glass 
every two hours, a baby taking only three pints of 
milk each day will start with only two ounces (one- 
quarter glass) every two hours. A child five to 
eight years of age who will take three quarts of 
milk should start with a half glass (four ounces) 
every two hours. The feedings should be increased 
two ounces a day up to six or eight daily feedings, 
after which the frequency of the feedings increases 
until the maximum quantity is reached. Thus, a 
child taking three quarts of milk a day will take a 
glass every hour, rather than a half glass every 
half hour. The adult takes the milk more fre¬ 
quently in order to get in the necessary quantity. If 
these proportions are observed the same directions 
may be used as for adults. 

Hardly ever will a solid food diet be required. 


210 


TREATMENT OF CHILDREN 

In some skin or gland cases, where the child is old 
enough to attend school and not ill enough to stay 
at home, the solid food diet will be more convenient. 
Even in these cases, however, it would be better to 
keep the child at home and give milk, at least until 
there has been marked improvement. Health is 
more important than education. However, if solid 
food seems to be indicated in any case, the diet 
should consist of the same foods and menus as ad¬ 
vised for adults unless the child is younger than 
three years. Of course, the quantities of food must 
be limited in accordance with the age, always being 
careful not to overfeed. This is often difficult where 
children are concerned, but if eating between meals 
is avoided there should be no trouble. If there 
seems to be a definite appetite an apple or some 
other acid or sub-acid fruit may be allowed, but 
nothing else. If the child is younger than three 
years the diet should consist chiefly of milk, fruits, 
cereals, eggs, and cooked vegetables. The raw 
vegetables are not so important for the young child, 
and in most cases they should not be used until 
around two and one-half years of age. The fruit, 
however, should be taken mostly raw. All cereals 
should be of the entire grains. One egg a day 
(preferably the yolk only) is sufficient up to five or 
six years of age, though if there seems to be a 
definite need for more concentrated nourishment 
an additional yolk a day may be given. Any of the 
cooked vegetables may be employed. Do not make 
the mistake of using nothing but potatoes or pota- 
211 


TUBERCULOSIS 


toes and carrots, or any other extremely limited 
variety. The green vegetables, such as spinach, 
kale and onions, and the lighter carbohydrates, such 
as cauliflower, egg plant, and summer squash, should 
not be neglected. A really normal adult diet need 



Outdoor exercise class for children having a tendency to 
tuberculosis. Here the combined advantages of the air, sun, 
bath and exercise are being secured. 

not be modified to any great extent for children ex¬ 
cept in regard to quantities and the proportion of 
raw vegetables. A fully raw food diet may be em¬ 
ployed, however, after three years, if plenty of milk 
is used. 

Regarding exercise, this need be given little at¬ 
tention. Rest will be more important for a time, 
and when ready for exercise the natural activities 
of the child will be sufficient. Play is the proper 
212 




TREATMENT OF CHILDREN 

exercise for children, and as much as possible of it 
should be done out of doors. It is not necessary to 
employ the systematic walking as in the case of 
adults. Simply employ the rest periods as has been 
advised, and then allow the child to run around as 
he desires. A child will stop when tired, and is not 
likely to overdo. However, children of a nervous 
temperament may need to be taught to relax and not 
to keep going when fatigued. Most children’s cases 
will be of the bones, in which complete rest is indi¬ 
cated, or of the skin and glands in which free activity 
usually is permissible. 

The question of splints and braces requires con¬ 
sideration. Children are inclined to squirm around 
more or less, even when lying in bed; and this, nat¬ 
urally, causes some motion of the bones and joints. 
Whether or not splints or braces should be used in 
such cases will depend largely upon the environ¬ 
ment that can be secured. If possible to secure sun 
baths for several hours a day and to have plenty of 
fresh air and proper diet there should be no neces¬ 
sity for braces, even in spinal cases. Dr. Rollier 
does not use them, and he gets good results. How¬ 
ever, many of the children of the poor cannot have 
such a good environment. They may be lucky to 
get the sun baths or ultra-violet radiations half an 
hour a day, the air is never any too fresh, and the 
milk they secure is not of the best quality. In such 
cases it may be well to employ sand bags or splints 
in spinal and hip-joint cases until there has been 
definite well established improvement. 

213 


TUBERCULOSIS 


Fresh air and sunlight are as necessary in chil¬ 
dren’s cases as in any others—perhaps more neces¬ 
sary. The air baths and sun baths should be used 
the same as for adults, except that for children 
under five years it is generally advisable to start 
with not more than a two-minute exposure, increas¬ 
ing two minutes a day up to a maximum of three 
hours daily. In very warm climates the air bath 
may be continued indefinitely; or in cases where 
there is not much sunlight the air bath may be con¬ 
tinued for the full period mentioned, even though 
the light exposure is limited. Care must be observed 
in cool weather that the air bath is not continued 
long enough to bring about chilling. When exposed 
to the sun it is easy to maintain warmth even if the 
air is cool. It is seldom necessary to protect the 
eyes except where the light is unusually brilliant, as 
at the seashore, and in cases of children less than two 
years of age. Older children will instinctively give 
their eyes any protection that may be needed. 

In giving the cool bath after the sun bath or at any 
other time it usually is prudent to start with tepid 
water at about 85 degrees and reduce gradually to 
60 degrees. The sponge bath or the wet-hand bath 
is the best for children. If any packs or compresses 
are needed they are to be given the same as for 
adults. In giving a general cold-sheet pack or hot- 
blanket pack, however, it may not be necessary to 
continue so long, as perspiration is usually produced 
sooner. Usually ten to twenty minutes of perspir¬ 
ing are sufficient. These treatments will not be 
214 



S 2 

§3 

U. 

<u 

£ 

3 
C 

co 
cd 


o 

£ 

CO 

ctf 

o 


o 

-m 

2 o 

C .Q 

i-l 

Ctf <L> 

r/» -C' 
CO 4 -j 

•—H 

o _, 

,§- s 
a 2 

•H 

<L> ctf 

2 <-> 

H T 3 
C 

. *« 
xn 

•r: xh 

O ^ 

tfl 

3 « 

o *o 

u. 

<u U 
43 <u 

a t: 
■m tJ 

o PQ 


o 1> 

c a 

<U o, 

■2 3 

§ cr 

£ <u 

nj « 

• <u 

g> * 

> £ 

2 ff 

** £ 

83 

*3 O 


o 

u 

o 


<u 

u 

3 


T3 
„ C 
o 

O <U 
•8-° 
” 3 
&.5P 

o g 
nd c 

■S >v 

5 « 

° .c 


c$ 


215 


permit the pupils to assume better postures, 
















TUBERCULOSIS 


required very often for children, but in youth they 
form a valuable part of the treatment in many cases. 

The use of mental therapeutics for children con¬ 
sists chiefly in keeping them interested and encourag¬ 
ing them. All children have very active imagina¬ 
tions. These should be appealed to, for the double 
purpose of keeping them occupied and for building 
a pattern of a strong healthy body in their sub¬ 
conscious minds. Games of various kinds and, 
perhaps, easy studies will serve the first purpose. 
For the second purpose, the child should be taught 
to imagine himself as being well in every particular, 
able to do all the things that other children do, and 
free from all pain or deformity. Whenever they 
have nothing else to do they can “day dream” along 
these lines. No one should ever suggest to the child 
that there is any doubt about recovery. All at¬ 
tendants should be cheerful, patient, and sympa¬ 
thetic. The use of music is often very helpful in 
entertaining the child, controlling moods, relieving 
tension, promoting sleep, etc. 

In very young children or where there is need 
for special assistance, suggestions may be given the 
patient about twenty minutes after going to sleep at 
night. These should be couched in the first person, 
using the pronoun “I.” For instance one may say 
for the child “I am breathing, eating, drinking 
health and strength.” “I feel new life and energy 
flowing through me, and all the functions of my 
body are constantly growing more normal.” “I 
am now tearing down the sick cells in my body and 
216 


TREATMENT OF CHILDREN 

building up new healthy ones.” “I am cheerful, 
happy, and confident.” Any similar ones which 
seem to meet the particular needs may be employed. 
Do not be doubtful about the child understanding. 
You are not talking to the conscious mind but to 
the guiding intelligence within the body that never 
sleeps, that always knows what to do. 

Children should always be treated at home if at 
all possible. They need the care of those most in¬ 
terested in them, and familiar surroundings will be 
a great help. For them to go away may lead to 
homesickness and undo all the good of the new en¬ 
vironment. Children respond readily to rational 
treatment, and if even a reasonably normal environ¬ 
ment can be created at home they will soon recover. 
The parents or guardians should not worry or allow 
the children to see them doubtful or afraid. Be 
confident, keep busy, give the child the necessary 
care but no more, and all will be well. 


217 


CHAPTER XII 

Complications and Their Treatment 

TN a properly treated case of tuberculosis of any 
kind there should be few, if any, complications. 
Complications usually result from neglect, improper 
treatment, or indiscretions on the part of the patient. 
This is especially true in the matter of diet. For 
such patients we can only do our best and wait for 
the time to come when suffering shall have taught 
them wisdom, at least discretion. However, compli¬ 
cations will sometimes occur no matter how careful 
the patient is or how good the treatment. These 
include hemorrhage, strains from coughing, and 
colds. Hemorrhage is really a symptom rather than 
a complication; but since it complicates the case when 
present and is sometimes absent even in severe cases, 
I am considering it here. Other possible complica¬ 
tions, such as pleurisy, empyema, digestive disturb¬ 
ances, neurasthenia, drug habit, etc., should not 
occur if care is observed. 

HEMORRHAGE 

Hemorrhage is an escape of blood from the 
blood-vessels. In tuberculosis it usually occurs only 
from the lungs or the intestines. When it occurs 
218 


COMPLICATIONS AND THEIR TREATMENT 


from the lungs it may be due to oozing from small, 
vessels or to rupture of a large vessel, either because 
of destruction of the vessel wall by a tubercle or 
because of strain from coughing or sudden violent 
exertions. When it occurs from the intestines it is 
generally due to destruction of blood-vessel walls 
by tubercles or ulcers. The quantity of blood lost 
may be anywhere from a mere trace to several 
ounces. However, it is not such a serious compli¬ 
cation as many people suppose. Under proper treat¬ 
ment hemorrhages will be absent or small and easily 
controlled. Of course, in a neglected case a large 
hemorrhage may be serious; but proper treatment 
will control it. An occasional streak of blood in the 
sputum or feces need be given no particular consid¬ 
eration. If there is enough to indicate a real hemor¬ 
rhage, however, special measures will be required. 

If the patient is not already resting he should go 
to bed at once and stay there for several days, or 
longer if the condition seems to require it. If al¬ 
ready in bed, care should be observed to be more 
quiet than usual, and even talking is to be prohibited 
for several days. Nothing but fruit should be taken 
for food, and that only as specially desired. Until 
the discharge of blood ceases, water taken should 
be cold, or from cracked ice melted in the mouth. 
If there is much discharge or if it continues for 
more than a few minutes an ice-bag may be placed 
on the chest, or cloths lifted from ice in a basin 
or lightly wrung from ice water may be used. Fresh 
air is important, as usual, but no deep breathing of 


TUBERCULOSIS 


any kind should be employed for several days. It 
is well to continue the fruit diet for at least one day, 
and in severe cases for two or three days. No hot 
drinks are to be taken, and hot food is avoided for 
a day or two after discontinuing the fruit diet. If 
sun baths are being taken they should be discon¬ 
tinued for several days; but ultra-violet radiations 
may be continued as usual, except for the one day 
on which the hemorrhage occurred. Either milk or 
solid foods may be resumed after the fruit diet, using 
only half the usual quantity for the first day and in¬ 
creasing gradually thereafter. 

Hemorrhage from the intestines should be treated 
as above, except that if the ice-bag is required it is 
placed over the abdomen instead of the chest, and 
if enemas are needed cool water, at about 70 de¬ 
grees, is used. Ice-cold cloths may be used in this 
case, also, instead of the ice-bag; but if cloths are 
used they must be changed every minute or two, as 
it is necessary that they be cold. 

STRAINS FROM COUGHING 

Coughing severe enough to produce strain usually 
occurs only in throat cases, where there is much 
local irritation and where swelling interferes with 
swallowing and elimination of mucus. Choking, 
also, is a possible source of strain in these cases. 
Coughing may be severe enough to produce strain in 
advanced lung cases or where the mucus is unusually 
sticky and tenacious. Careful general treatment 
should soon relieve the cough sufficiently that possi- 
220 


COMPLICATIONS AND THEIR TREATMENT 

bility of this complication will be removed. The 
abdomen is usually the part strained. 

When a slight strain occurs it will require only 
rest. If the strain is sufficient to produce rupture 
(hernia) a properly fitted support must be worn, 
as the special exercises for this condition cannot be 
taken until the general health has been greatly im¬ 
proved. Rupture is quite unlikely to occur when a 
patient is resting. A good means of preventing 
rupture, when there is severe coughing, is to draw 
the thighs slightly toward the abdomen, especially 
when lying on the back. This places a slight tension 
upon the muscles in the regions where rupture may 
develop, and this usually is sufficient to prevent this 
mishap. The more probable condition to develop 
from coughing is prolapsus of the abdominal or 
pelvic organs. This may occur even if the cough¬ 
ing is not severe, if it is constant. The muscles, liga¬ 
ments, and other tissues being already weakened by 
the disease, the marked downward pressure occa¬ 
sioned by frequent coughing may cause the organs 
to drop below natural position. This is possible 
even when the patient is lying down much of the 
time. If the general condition will permit, a few 
tensing exercises for the abdominal muscles followed 
by a cold compress for three minutes will help to 
keep the internal structures in tone. It also is a 
good plan to assume the knee-chest position or to lie 
on the back with hips elevated on a pillow for five 
to ten minutes at a time several times per day, both 
for prevention and correction. Retraction of the 
221 


TUBERCULOSIS 


abdomen—drawing in the abdomen and drawing up 
the diaphragm—should be practised frequently dur¬ 
ing the day. It is an excellent preventive and cor¬ 
rective of prolapse of organs. 

The lungs, as well as the abdomen, may be 
strained by violent coughing. This may produce 
hemorrhage, and in any case there will be some 
soreness. The hemorrhage should be treated as al¬ 
ready described. The only thing necessary for the 
soreness is rest and the general treatment. If the 
cough is obstinate or if there is much soreness it may 
be well to strap the chest with adhesive plaster, as 
in case of pleurisy, in order to protect it. It is not 
well, however, for the patient to fear that he will 
tear the lung tissues every time he coughs. These 
tissues are quite elastic, and even when there is con¬ 
siderable scar tissue there will be sufficient “give” to 
prevent much trouble. As the proper treatment 
is continued there will be less and less cough. 

Another possible effect of excessive coughing is 
vomiting. The contraction of the abdominal mus¬ 
cles and the movements of the diaphragm may so 
upset the stomach that regurgitation occurs. A re¬ 
duction of food will be helpful in these cases. The 
vomiting seldom occurs except in those patients who 
overeat and overload the stomach. 

COLDS 

Colds will sometimes result no matter how care¬ 
ful one is to eat properly, avoid undue exposure, and 
harden the body through air baths, sun baths, and 
222 


COMPLICATIONS AND THEIR TREATMENT 

cold baths, and fresh air. They are not so frequent, 
however, if the patient can live out of doors; and, 
of course, proper treatment will keep them at a 
minimum. If a cold should occur it should be 
treated as colds developing at any other time. The 
fruit diet, with daily enema, should be adopted until 
the most of the symptoms have subsided. The 
regular treatment for the tuberculous condition 
should then be resumed. It is advisable to rest 
during this time even though one has reached the 
point where exercise is permissible. The occur¬ 
rence of the cold indicates that there has been some 
accumulation of toxins or lowering of the vitality, 
and it is best not to take any chances of having a 
set-back. A few days on fruit, with rest, will prac¬ 
tically always set everything right again. 

PLEURISY 

This condition often causes considerable trouble 
in cases where the lungs are affected. It may arise 
from infection from a tubercle located close to the 
surface of the lung, because when tuberculosis is al¬ 
ready present all parts of the body are rather sus¬ 
ceptible to infection of any kind. A neglected cold 
also may be a factor, since the pleura, in common 
with the lungs, has had its resistance lowered. If 
the causes of the tuberculosis have not been re¬ 
moved pleurisy may develop at any time, for it is 
due to the same fundamental causes. But whatever 
the cause, strict treatment will be required. 

Absolute rest must be observed, and nothing but 
223 


TUBERCULOSIS 


a limited amount of fruit juice with plenty of water 
is to be taken until all morning fever is gone, and, 
if the weight and strength will permit, until fever 
at any time of the day has disappeared. A hot-blan¬ 
ket pack at the start of treatment is very helpful. 
After that hot water bottles are applied over the 
affected parts until pain has been relieved. Cough¬ 
ing should be restricted as much as possible. The 
patient will make every effort to do this, because 
coughing produces keen pain in pleurisy. Fresh air 
is of supreme importance. If coughing is very pain¬ 
ful and continues in spite of treatment, the chest may 
be strapped with adhesive plaster. No more strap¬ 
ping is applied, however, than is necessary to give 
relief. Usually only one side is affected. The ad¬ 
hesive is passed from the opposite side of the spinal 
column around the affected side and over the breast 
bone. The plaster should be one and one-half or 
two inches wide. It is drawn quite snugly when 
the chest is as small as possible from exhaling, and 
as many strips are applied as necessary, overlapping 
each one slightly. Generally it is well to start near 
the bottom of the chest and work upward. New 
plaster should be applied each day, especially if 
there is much perspiration. If the weather is cold, 
care must be observed not to chill the patient while 
applying the strips. The strapping is discontinued 
as soon as the condition will permit. 

If the pleurisy is of the “moist” variety and there 
is much swelling from the effusion of serum, a hot 
chest pack may be applied daily until this symptom 
224 


COMPLICATIONS AND THEIR TREATMENT 


has been relieved. Twenty to thirty minutes is 
usually long enough for this pack. Hot-water bot¬ 
tles may be placed over the pack to maintain heat. 
It is generally advisable to avoid strapping in these 
cases. 

If the case is very bad or not properly treated, 
pus may accumulate within the pleura, giving rise 
to the condition called empyema. An operation may 
be required for this condition if the pus does not 
drain or is not soon absorbed; but usually the above 
treatment will be sufficient. 

There is considerable likelihood of adhesions 
forming after an attack of pleurisy. The inflamma¬ 
tion, on subsiding, leaves scar tissue binding the two 
layers of the pleura together, or sometimes the scar 
tissue may extend from the pleura to the diaphragm 
or up into the lungs. This causes pain and some 
limitation of the motion of the lungs or chest 
walls or both. After all symptoms of the pleurisy 
have subsided the practise of careful deep breath¬ 
ing, gradually increasing the depth of the breaths 
taken, will partly break up these adhesions and 
partly stretch them so that they will cause no notice¬ 
able trouble. When the condition has progressed 
far enough to permit general exercise, further im¬ 
provement in the adhesions may be obtained. 

DIGESTIVE DISTURBANCES 

There should be little or no digestive disturbances 
when the right treatment is followed. They arise, 
chiefly, from the orthodox practise of overfeeding 
225 


TUBERCULOSIS 


and the use of medicines for suppressing symptoms. 
Improper combinations of foods, highly seasoned 
foods, the use of tea, coffee, and cocoa, or the over¬ 
use of concentrated foods may be causes. All of 
them will be avoided when the suggestions given 
in this book are followed. However, practically all 
tuberculous patients have rather weak digestion, 
and disturbances may occur even on a careful diet. 
The various modifications of the milk diet which 
may be used for special disturbances while on that 
diet have been described. If there are any special 
foods or combinations of foods that seem to disa¬ 
gree when on solid foods, these should be avoided 
until the condition has improved, even though they 
would be all right under ordinary circumstances. 
If there is much gas in the stomach after a meal, sip¬ 
ping a little of quite hot water will usually dispel it. 
If the gas is in the intestines, an enema may be taken, 
even though the bowels are moving well or an enema 
has been used previously during the day. Hot ab¬ 
dominal compresses are helpful, also. 

If there is nausea, vomiting or other more marked 
symptoms, a fast should be taken for a day or more, 
even when one of the regular fasts or fruit diets has 
been recently taken. Hot water should be used dur¬ 
ing this time. After this, greater care must be ob¬ 
served in adhering to all the rules of eating, and 
the quantity of food should be limited for several 
days. If there is considerable nausea without vom¬ 
iting it may be well to drink several glasses of warm 
water, and then place the finger in the throat to in- 
226 


COMPLICATIONS AND THEIR TREATMENT 


duce vomiting. This method may be used, also, for 
washing out the stomach in the morning before tak¬ 
ing anything for the day, if the previous day’s ra¬ 
tions have not seemed to “set” well. Such an occa¬ 
sional stomach washing is of value in any case. The 
use of several glasses of water makes vomiting sur¬ 
prisingly easy and free from distress. 

Diarrhea not due to tuberculous infection of the 
intestines should be treated by a fast of a couple of 
days, with the free drinking of water and a high 
enema each day to remove thoroughly the offending 
material which the body is endeavoring to throw 
out. Less rough food should be eaten for a few 
days thereafter. Diarrhea, which may occur on the 
milk diet, has been discussed in an earlier chapter. 

The regularly repeated fruit diets I have recom¬ 
mended will do much to avoid digestive disturb¬ 
ances; and, of course, it is much better to prevent 
them. Avoidance of overeating, and strict atten¬ 
tion to diet and all phases of treatment I have de¬ 
scribed will do the rest of the preventing. 

NEURASTHENIA 

When a patient is first told that he has tuber¬ 
culosis, this information is very depressing. Hence, 
all patients are possible subjects of neurasthenia. 
Fortunately, however, most of them react quickly 
and become quite optimistic. Usually it is only those 
who are improperly treated or whose environment is 
very bad that develop well marked neurasthenia. 
Overfeeding, overresting, drugging, and exile from 
227 


TUBERCULOSIS 


home are especially likely to be causes. Failure to 
observe complete sexual rest, and various forms of 
sexual perversion are prominent causes. Financial 
or other worries may lead to neurasthenia. But 
whatever the cause, it is necessary to give careful at¬ 
tention to every phase of the right treatment in 
order to secure favorable results. 

Of course, removal of causes will be of pri¬ 
mary importance; but some of them may be found 
very difficult to remove. Homesickness, financial 
cares, poor environment, etc., may be almost impos¬ 
sible to correct, and the patient will have to adapt 
himself to them. Hence, mental treatment is par¬ 
ticularly important. Autosuggestion and the study 
of practical psychology will be found very helpful in 
cultivating hope, confidence, faith, trust, determina¬ 
tion, persistence, cheerfulness, and patience. De¬ 
termined practise in the expression of these mental 
attitudes, however, is the only way to get the bene¬ 
fit of them. The patient should realize that upon 
doing so depends his recovery and his happiness. 
Inspirational and instructive reading also will be of 
much assistance, as it will not only keep the patient’s 
mind off himself but will concentrate it upon con¬ 
structive thoughts and will build the foundation 
for a helpful philosophy of life. When a patient 
knows how his mind and body works, and some¬ 
thing of how to care for them, he has greater con¬ 
fidence in his ability to control himself and his 
environment. 

Two other things that are of value are the use 
228 


COMPLICATIONS AND THEIR TREATMENT 


of color and music. The best colors with which to 
surround the patient are yellow, orange, and white. 
Flowers are always excellent. In regard to music, 
this must be adapted to the needs at the time. Prac¬ 
tically everyone reacts to certain tunes in the same 
way, and everyone knows which ones are stimulating, 
which soothing, which depressing, and which uplift¬ 
ing. Often a radio is very helpful, though it must be 
used with discretion, since there is so much clatter 
and irritation in so-called “popular” music and 
“jazz.” 

After all, preventing and treating neurasthenia 
consists merely in giving careful attention to all the 
measures I have suggested in previous chapters, 
that the body may be cleansed of irritating toxins, 
the vitality increased, the environment kept as fa¬ 
vorable as possible, and the cure expedited. 

DRUG HABIT 

There is really no excuse for the development of 
this habit by tuberculous patients, or by anyone else, 
for that matter. If the various narcotics were not 
employed for suppression of the tubercular cough, 
as is so frequently the case, there would be no op¬ 
portunity for the development of drug addiction. 
The use of local anesthetics in extreme cases of 
laryngeal tuberculosis is very unlikely to produce 
such a habit. It is the use of “cough medicines” and 
“sleeping powders” which is really to blame. 

Once such a habit has developed it may be difficult 
to break it, for the patient is not in a condition to 
229 


TUBERCULOSIS 


endure strenuous eliminative treatment. The use of 
mental suggestion is here of much value. It can be 
given after the patient has gone to sleep, as sug¬ 
gested in the chapter on treatment of children. 
However, for best results the patient himself also 
should use suggestion, constantly assuring himself 
that he has perfect control of all his thoughts and 
actions and has no desire for anything but the nor¬ 
mal things of life. Use of the drug should be 
stopped immediately if at all possible. A fast of 
a few days should be taken, with large quantities 
of water, and sweating should be employed as far 
as the condition will permit, to remove the accumu¬ 
lated poison and thus reduce the physical craving. 
Of course, careful and constant attention must be 
given to the general treatment at all times, to re¬ 
move the symptoms for which the drugs were given. 

TUBERCULOSIS MENINGITIS 

I am considering this as a complication of tubercu¬ 
losis because it is almost always an extension from 
tuberculosis in some other part. It occurs chiefly 
in children, and is most often a complication of 
scrofula or spinal tuberculosis. It is an inflamma¬ 
tion of the membranes covering the brain (the 
meninges), and is a very serious and, usually, fatal 
disease. However, it seldom 1 develops in properly 
treated cases. 

The first symptoms are irritability, headache, in¬ 
somnia, and loss of appetite. As the condition ad¬ 
vances the headache becomes more severe, and 
230 


COMPLICATIONS AND THEIR TREATMENT 


ther develop vomiting and convulsions. The tem- 
perlure varies from 99 degrees in the morning to 
10 or 103 degrees in the afternoon, and the pulse 
is qite irregular. This stage usually lasts about 
tw /eeks and is followed by depression, with slow 
puls, lowered temperature, and stupor alternating 
withdelirium. Collapse, coma, and death' generally 
folkv. This is not a pleasant picture, but it em- 
phaizes the necessity for proper treatment at the 
star When this is done there is a reasonable 
chace of recovery. 

be treatment can be summed up in a few words: 
no 6 od except possibly a little fruit juice, rest, fresh 
air ay and night, enemas daily, and cold wet-sheet 
pack every day until fever is broken or every other 
dayif very weak. If the patient is weak but without 
fevc it may be well to give a hot abdominal pack 
for nout thirty minutes in place of the cold wet- 
shec pack. If the spine is not affected to such an 
extet as to make movement inadvisable, a hot half¬ 
bat with cold affusions to the upper spine and 
ches, may be used. This bath is taken by having 
the atient sit in about twelve inches of hot water 
whil cool water is poured over the spine and chest 
frot a large vessel, followed by brisk friction to 
brin about reaction. The affusion may be repeated 
twoor three times and the bath continued for five 
to tn minutes. If the symptoms seem to be de- 
veloing rapidly the bath may be repeated several 
time during the day, always with care to see that 
recueration from one bath has occurred before 
231 


TUBERCULOSIS 


giving another. If the patient becomes much weak¬ 
ened there will be no use in giving another bath, be¬ 
cause he will not have the strength to react; and 
it is the reaction that is of benefit. In such a se¬ 
rious condition as tuberculosis meningitis, the chief 
dependence must be placed upon the patient’s own 
inherent vitality and resistance. The policy of 
“hands off,” using treatments only as very necessary 
to control the most severe symptoms, is a good one 
to follow, though it is often difficult because others 
are inclined to think that nothing is being done for 
the patient. The truth of the matter is that rest, 
fresh air and water will do more for the patient 
than anything else. 

When complications develop in any case, greater 
care and patience are necessary on the part of both 
the afflicted one and his attendants. It is always 
much better to avoid complications, as tuberculosis is 
difficult enough without them. The important point 
to remember is that early removal of causes will do 
away with the necessity for complications, because 
these appear only when necessary—the same as do 
the usual symptoms of tuberculosis. Will power is 
necessary in following the prescribed regimen every 
day, and some patients will need the warning of com¬ 
plications before they will employ this very neces¬ 
sary mental attribute. The prudent ones, however, 
will realize that a little “moral suasion” at the start 
will pay big dividends in early, uncomplicated re¬ 
covery. 


232 


CHAPTER XIII 
After-Care of Tuberculosis 


/ I V HE after care in any case of tuberculosis is 
always important. Convalescence is usually 
slow. It has required all the energy which the body 
was able to generate in order to eliminate the causa¬ 
tive toxins and repair the damaged tissues; and it 
will take a little time for a sufficient surplus to be 
accumulated to give the patient that resistance which 
will be necessary before he can return fully to all 
the activities of everyday life. Therefore, it will 
be advisable for the patient to observe care in re¬ 
spect to every phase of living for some time after 
the tuberculous lesions themselves have healed. 

The patient must not think that because the im¬ 
perative necessity for rest is past or because the milk 
diet is no longer specially needed, he can immedi¬ 
ately be as active as he desires, eat everything that 
pleases his fancy, and expend his energies as he 
pleases. Precautions must still be observed to regu¬ 
late the diet, get plenty of fresh air, cultivate the 
sunshine, graduate the exercise, secure adequate 
rest and sleep, and think the right kind of thoughts. 
It will always be necessary to diet, to a certain ex¬ 
tent; that is, one cannot return to his old diet, be¬ 
cause it was not a normal one and it may produce 
233 


TUBERCULOSIS 


recurrence of the disease. He must live indefinitely 
on natural foods. This will not be denial, but a 
pleasure, after having employed rational methods 
of treatment. The normal diet consists of fruits, 
vegetables, nuts, whole grain products, honey, milk 
and milk products and eggs. Raw foods are always 
important. 

If one can arrange to sleep outdoors indefinitely 
it would be an excellent arrangement. Sun baths 
are good even for a healthy person. Directions for 
graduating the exercise have already been given. 
Every effort should be made to secure nine hours 
of sleep at night, and one rest period during the 
day if possible. Do all these things with the idea 
that you are promoting health and not fighting dis¬ 
ease, that you are improving your efficiency and not 
merely avoiding punishment. Let all your thoughts 
be constructive in character. 

Other factors that will need consideration are 
occupation, social activities and amusements, cli¬ 
mate, etc. Regarding occupation, if one has re¬ 
stored his health through natural methods of treat¬ 
ment to the extent that the body has been cleansed 
and the vitality increased, it is not so important 
to choose a vocation that is especially favorable 
from a health standpoint. Of course, if this can 
be done it is always best; but if one lives rightly 
he should be able to follow almost any occupation 
without injury to his health, except possibly those 
which are extra hazardous from the standpoint of 
lung affections, such as caisson workers, miners, 
234 


AFTER CARE OF TUBERCULOSIS 

glass blowers, steel workers, cigar makers, etc. 
Some cases will need to return to work at the earli¬ 
est possible moment on account of finances. These 
should choose work which will permit them to con¬ 
tinue their regular healthful regimen as far as pos¬ 
sible. The vocations of gardener, landscape artist, 
tree surgeon, and chicken farmer are especially valu¬ 
able. Others which are usually listed as favorable 
include banker, barber, cabinet-maker, clerk, clergy¬ 
man, draftsman, lawyer, librarian, merchant, opti¬ 
cian, teacher, etc. But these usually do not give 
enough fresh air or exercise. Of course, if the hours 
of work are not long one can make up for these 
defects when not working. For those in good con¬ 
dition when they start work the various trades are 
good, such as bricklayer, carpenter, electrical 
worker, mechanic, and paperhanger; but plastering, 
painting, and plumbing are not so good. Other 
good occupations include masseur, canvasser, col¬ 
lector, salesman (not clerk), reporter, and farmer. 
In most cases it is well to avoid working as a janitor, 
garage mechanic, stone cutter, miller, typesetter, or 
undertaker, because of the various foreign materials 
which one is likely to breathe in or absorb in other 
ways. 

In regard to social activities, the less “indoor 
sports” indulged in the better. A reasonable amount 
of visiting with congenial friends, or even dining 
with them if they eat sensibly, is all right; also an 
occasional card party, dance, or theatre party. 
Avoid late hours, however, and let your recreations 
235 


TUBERCULOSIS 


be out of doors rather than indoors. Hiking, 
bathing, boating, golf, or a mild game of tennis 
are all good. You may be warned against any form 
of activity that uses the arms or causes deep 
breathing; but when you have prepared for 
these by the graduated walking and other exer¬ 
cises already advised, you may disregard all such 
warnings. Quite naturally, any new form of activ¬ 
ity must be started with care and increased gradu¬ 
ally, and excessive fatigue is always to be avoided. 
Under any circumstances such outdoor activities are 
never likely to be so dangerous as dances extending 
into the “wee sma’ ” hours of the morning, “stag 
parties,” poker games, petting parties, or even 
spending long hours in a theatre. Let your amuse¬ 
ments as well as your other habits of living be con¬ 
structive rather than destructive. 

If the patient has left his home and made a rad^ 
ical change in climate with the idea of hastening 
his cure, it would be well to remain in that climate 
until a perfectly normal condition has been restored, 
or sometime thereafter if possible. Return to the 
former climate should always be accompanied with 
such changes in the habits of living as may be nec¬ 
essary. For instance, if one has changed to a cold 
climate and is returning to a hot climate, it will be 
necessary to eat more lightly and use more fruits 
and vegetables. If the opposite conditions obtain it 
may be well to increase moderately the amount of 
fats or starches in the diet. When changing to a 
colder climate it is always important to avoid stay- 
236 


AFTER CARE OF TUBERCULOSIS 

ing indoors too much. Be sure to get the same 
amount of fresh air as usual, even if it is cold. 
Most cases which go away for treatment seek high 
altitudes. In returning to a low altitude it will take 
a little time to become acclimated again; but if care 
is observed to eat lightly and get plenty of fresh air 
there should be no trouble. Air baths and sun baths 
are especially important at such a time, as they 
afford some of the stimulation which is felt in a 
high altitude. As a rule it is not well to seek treat¬ 
ment at an altitude of more than 2,500 feet, as a 
greater height will be of no special assistance and it 
is easier to return from the lesser altitude to the 
native climate and low altitude. 

While it is necessary to observe care during con¬ 
valescence this should not be carried to such extremes 
that the patient becomes afraid to make a move 
or to change his routine in any way. Such extreme 
care leads to neurasthenia, which makes real prog¬ 
ress very difficult. As soon as fear enters in there 
is bound to be trouble. Do what is necessary to do 
not because you are afraid to do otherwise but be¬ 
cause in so doing you are following Nature’s laws, 
which make for health and happiness. 

I have seen some patients who, after taking the 
conventional rest cure, were afraid to make the 
slightest unusual exertion, such as carrying a travel¬ 
ing bag from their room to a taxi. Others who were 
supposed to be cured were unable to walk a block 
without getting out of breath, and, in consequence, 
were afraid to do anything but ride. After having 
237 


TUBERCULOSIS 


“fed up” according to directions, patients are often 
afraid to miss a meal or make any reduction in the 
quantity of food taken even though they have no 
appetite, for fear that they might lose an ounce 
or two of weight and plunge headlong into a relapse. 

Such exaggerated precautions are by no means 
necessary. The conditions and changes usually 
feared are not likely to cause trouble when the 
proper treatment (from which fear has been ex¬ 
cluded) has been taken. I remember the case of 
one young man who secured a position in a grocery 
store after completely recovering from his trouble. 
He did all the necessary physical work, including 
lifting quite heavy boxes, without fear and without 
harm. Some of his friends attempted to dissuade 
him, warning him that such work might cause a re¬ 
lapse. But he refused to be frightened and went 
ahead with confidence, continuing to take proper 
care of himself. This is the right attitude. The 
thing to do is to use plain common sense, give par¬ 
ticular attention to avoiding the disease and forget 
about coddling and its effects. 


238 


CHAPTER XIV 

Prevention of Tuberculosis 



HIS book is written primarily for those who 


A already have tuberculosis. They are not so 
interested in prevention. But I cannot leave out this 
important subject entirely. Anyone who has had 
tuberculosis, even the most misanthropic, will not 
wish anyone else to have it; and some information 
on prevention will help them to help others. Then 
those who are in attendance on the patient will also 
wish to know how to prevent developing the disease. 

The prevention of tuberculosis is largely a mat¬ 
ter of education. The people must learn how to 
live. Disease is a result of improper habits of liv¬ 
ing. If we learn the right kind of habits and then 
practise them persistently we will be protected from 
all diseases. Avoid causes and there will be no ef¬ 
fects. Hence, if you wish to prevent tuberculosis 
read the chapter on causes and avoid all of these 
causes. This sounds simple enough; and truly it is 
not too difficult, but many people make it so by 
refusing to make up their minds to live rightly. 
This is where education comes in. Constant study 
of right habits of living will, in time, create a desire 
to live correctly. This business of teaching people 
how to live has been my work for many years, espe- 


239 


TUBERCULOSIS 


daily through Physical Culture Magazine and my 
Health Library. 

While a careful study of the chapter on causes 
will give you much information on how to prevent 
tuberculosis, I wish to call your particular attention 
to certain points The first is the necessity for 
avoiding fear. Humanity as a whole has been so 
accustomed to fearing something or other ever since 
the dawn of creation that it is often very difficult 
not to fear the things that most people consider 
evil. Tuberculosis usually is regarded as such a ter¬ 
rible disease that it is almost instinctive to fear it. 
Great care must be observed, especially by those 
attending a tuberculous patient, to keep their minds 
so occupied with constructive thoughts that they will 
be constantly protected from the fear thoughts. 
The directions I have already given for autosugges¬ 
tion will be of the greatest assistance in this respect. 
Also, constant repetition of the thought (which is 
a fact) that tuberculosis cannot develop in a healthy 
person will tend to produce calmness, poise, and con¬ 
fidence, especially when it is realized that health is 
a natural result of right living and within the reach 
of all. 

After conquering fear and also while doing so, 
careful attention must be given to cleanliness, the 
use of fresh air and sunlight, the practise of regular 
exercise and proper diet. Sunlight is of special 
value in dispelling fear, as well as germs, and in 
keeping the vitality high. Everyone should use it 
whenever the opportunity offers. Attendants of 
240 


PREVENTION OF TUBERCULOSIS 

tuberculous patients should take the baths the same 
as do the patients, and should use the ultra-violet 
rays if sunlight is not available. It hardly seems 
necessary to reiterate the necessity for fresh air, 
but it is so important that I must do so. One who 
lives largely out of doors and either sleeps outside 
or has plenty of ventilation at night is not likely 
to develop tuberculosis even though his other hab¬ 
its of living leave much to be desired. Fresh air is 
especially important for relatives and attendants of 
the patients. They will probably be outside consid¬ 
erably with the patient; but they should also sleep 
out if at all possible. Breathe the fresh air deeply, 
to get the most benefit of it. 

BREATHING EXERCISES 

I am giving herewith a number of breathing exer¬ 
cises that will serve as examples. Variations of 
these are easily devised if one finds constant use of 
the same ones monotonous. 

1. Exhale fully, then inhale slowly through the 
nose, expanding the lower lungs first, then the mid¬ 
dle portions, then the upper. 

2. Inhale, carrying in mind the thought that you 
are breathing in life, energy, health, and strength. 
Exhale, carrying in mind the thought that you are 
blowing out all impurities and undesirable thoughts. 

3. Exhale fully, inhale (through the nostrils) to 
comfortable fullness, hold the breath for two sec¬ 
onds, then exhale suddenly and completely through 
the open mouth. 


241 


TUBERCULOSIS 


4. Inhale through one nostril, holding the other 
closed with a finger. Exhale through the same nos¬ 
tril. Reverse and breathe through the other nostril. 

5. Inhale fully, then exhale in a series of puffs 
through the pursed lips. 

6. Inhale fully, then exhale through the nose by 
humming the sound “m” at the pitch of “E” above 
middle “C ” 

7. Inhale while raising arms sideward upward 
overhead, stretching well upward, and exhale while 
lowering the arms. 

8. Extend the arms forward shoulder high, then 
pull backward, bending the elbows, as though pull¬ 
ing a chest weight until the hands are in front of 
the shoulders. Inhale during this movement and 
exhale as the arms are again extended forward. 

9. Draw the shoulders forward while exhaling, 
then inhale as you roll them upward and backward. 

10. While in reclining face-up position with arms 
at sides, inhale as you raise the arms overhead, ex¬ 
hale as you lower the arms. 

Cleanliness is a very important factor and extends 
not only to the inside and outside of the body but 
to the clothing, bed clothing, house, and general 
environment. Germs cannot exist where plenty of 
water, soap, air and sunlight are employed. A 
cleansing bath should be taken twice a week, and a 
dry friction and cold water bath daily. The cloth¬ 
ing should be changed as frequently as necessary, in 
no case wearing it so long that it becomes un¬ 
sightly or has an unpleasant odor. Underclothing 
242 


PREVENTION OF TUBERCULOSIS 

and hosiery may be changed every day to advantage, 
though this may not always be absolutely neces¬ 
sary. After washing, the clothing should be dried 
out of doors in the sunshine. The same applies to 
the bed clothing. The blankets and comforters or 
fur robes, if these are used, should be aired and 
sunned frequently. A vacuum cleaner is best for 
cleaning rugs, draperies, and furniture, as this cre¬ 
ates no dust and cleanses thoroughly. All garbage 
and other wastes should be burned or otherwise sat¬ 
isfactorily disposed of at regular intervals, so that 
none accumulates. In cities where there are sani¬ 
tary plumbing arrangements and garbage is collected 
regularly, individual garbage incineration is not so 
necessary. Attendants of tuberculous patients, how¬ 
ever, should see that the sputum cups or napkins are 
burned. The patient himself should observe care 
always to employ such cups or napkins, for his own 
sake as well as others—and not expectorate in any 
open receptacles or in any place where the expec¬ 
toration cannot be completely destroyed. 

Nothing takes the place of exercise in keeping 
the elimination active, and when this is accomplished 
there will be a clean body inside. Most of us are 
inclined to neglect exercise, either from laziness or 
because we think we have no time for it. But if 
one wishes to keep well one will have to see that 
some exercise is taken regularly and daily. This 
also is especially important for those in more or less 
close association with someone having tuberculosis. 
Those looking after the patient may be very busy 
243 


TUBERCULOSIS 


and may be inclined to think they have no time for 
exercise. But they must manage to get at least a 
walk every day. Trained nurses always insist upon 
time off for walking every day, and it is a wise pre¬ 
caution. An hour of such exercise will do much to 
prevent a lowering of the vitality or an accumula¬ 
tion of poisons which might lead to tuberculosis. 
Then it only takes ten minutes or so to go through 
a little series of calisthenics. Added to the walking 
this will take care of the requirements of most per¬ 
sons who actually do not have time for more. 

In regard to diet, the important points to re¬ 
member are to secure plenty of mineral elements and 
vitamins, and not to overeat. For this purpose the 
raw fruits and vegetables are the most valuable. 
Milk is a very effective protective agent; but since 
it contains a lot of “solid food” there is danger of 
overeating if one drinks much of it with regular 
meals. Often a good plan is to make one meal a 
day of nothing but milk and acid or sub-acid (or 
both) fruits. The necessary raw vegetables may be 
secured by always including a large salad in one or 
two meals a day. Nuts and egg yolks are better 
forms of protein than meat, or even than cheese, 
because they contain a larger proportion of the min¬ 
eral elements. Therefore, let them supply most of 
your protein. Carefully avoid all the dietetic errors 
listed in the chapter on causes of tuberculosis. 

Of course, for some people it is very hard to se¬ 
cure the proper foods at all times and to get plenty 
of fresh air and rest. Poverty, isolation, a severe 
244 


PREVENTION OF TUBERCULOSIS 

climate, etc., may all interfere. Hence, to be really 
effective in preventing tuberculosis it is necessary 
that social conditions be improved. The means for 
doing this cannot be adequately covered in a book 
of this kind. Education is a primary factor. Igno¬ 
rance is responsible for most of the world’s troubles 
—ignorance of Nature’s laws and how to use them. 
Even the poorest people could live better than they 
do if they knew how. Vicissitudes in climate can be 
discounted by proper living habits that will adjust 
the individual to his environment. Proper education 
along health lines will enable anyone to make the 
most of the facilities he has at hand, no matter 
how limited, and thereby render tuberculosis and 
other diseases much less likely. Poor people who 
are constantly driven to earn a living are especially 
prone to dissipation of various kinds. They feel 
that they must crowd the most sensual enjoyment 
into the shortest period, since they have so little time 
for what usually are called pleasures. They must 
be brought to realize by proper education that sen¬ 
sual pleasures are not the real and enduring ones, 
and that they lead only to sickness, misery and 
death. The simple wholesome pleasures can be en¬ 
joyed by all. When we learn to be satisfied with 
these we shall have learned real wisdom. After all, 
what pleasure can compare with the pleasure of 
health? The tuberculous patient particularly will 
answer most emphatically “None!” So let those 
who wish to avoid tuberculosis take the patient’s 
word for it and live rightly in every respect. 

245 


CHAPTER XV 


Equipment for Treating Tuberculosis 

UBERCULOSIS is a disease that calls for 



A some special equipment for treatment. In 
treating most diseases the patient will find it readily 
possible to secure the advantages of Nature’s forces 
—fresh air, sunlight, water, proper food, exercise, 
etc., and no special arrangements or specific equip¬ 
ment will be required. But in tuberculosis the neces¬ 
sity for both fresh air and rest and the importance 
of sun baths or ultra-violet radiations, together with 
the need for extra sanitary precautions, so compli¬ 
cate the matter that at least some equipment is both 
necessary and helpful. Within reason, the more of 
such equipment the patient can obtain the more men¬ 
tal peace will he have, because everything will be 
more convenient, and taking the necessary treat¬ 
ment will not require so much mental or physical 
exertion. Naturally, recovery will be quicker under 
these circumstances. The expenses involved need 
not be great, as various substitutes usually may be 
employed for specially manufactured articles. How¬ 
ever, whatever expense is involved will be worth 
while, because of the greater effectiveness of the 
treatment. Of course, a patient with sufficient de- 


246 


EQUIPMENT FOR TREATING TUBERCULOSIS 

termination, patience and self-control can get well un¬ 
der very adverse conditions. No one should feel that 
recovery is impossible because he can not obtain some 
desired bit of equipment. The patient should ob¬ 
tain what he can and avoid worrying about the rest. 
The first question which always comes up when a 



A winter scene in the Adirondack Mountains. This section is 
famous as a health resort for tuberculous patients. Note the 
sleeping porches on the house. They are inexpensively made 
and fully serve their purpose. The sliding glass windows may 
be opened as much or as little as desired. 

person finds that he has tuberculosis is whether oT 
not sanitarium treatment will be instituted. Three 
plans are open to the patient. He can go to a 
sanitarium, or to a health resort, or he can stay at 
home. The medical doctor usually will recommend 
them in the order named—go to a sanitarium if you 
can; if not, then go to a health resort; and if this 
is impossible, then do the best you can at home. 
In most cases I would recommend just the opposite 
procedure, though of course there are advantages 

247 




TUBERCULOSIS 


and disadvantages in all plans. The patient will 
have to weigh these one against another and decide 
which plan best suits his own individual needs, de¬ 
sires, and purse. What is excellent for one may be 
contraindicated for another. Sometimes there will 
be some special feature of the case that will decide 
the matter immediately—such as when the patient 
is too sick to move. In this case he will be saved 
considerable mental exertion. 

In considering which plan will be the best the 
following information may prove helpful: 

In regard to sanitarium treatment, this plan will 
be automatically vetoed in the majority of cases, for 
there are not enough sanitariums to go around. 
There are probably not more than one-third as many 
available sanitarium beds as there are patients. Con¬ 
sequently they all have a waiting list, and one may 
be dead before he can be admitted. Because of 
this demand most such institutions limit their cases 
to mild ones, which they are fairly certain can re¬ 
cover. There are very limited accommodations for 
desperate ones. Most patients with such cases must 
shift for themselves, as under the circumstances they 
are not considered sufficiently u good risks”—they 
pull down the percentage of cures, and, therefore, 
are not favorable advertising. As a matter of fact, 
these are the cases which most need sanitarium treat¬ 
ment, for there they can secure the constant atten¬ 
tion and the favorable general environment which 
they need so badly. 

The chief advantage in tuberculosis sanitariums 
248 


EQUIPMENT FOR TREATING TUBERCULOSIS 


properly conducted and equipped, is that all the nec¬ 
essary facilities are readily available. There are 
sleeping porches and “cure” porches, hospital beds 
and reclining chairs, sanitary equipment, sun par¬ 
lors and ultra-violet lamps, special diet facilities, 
constant supervision, nursing when needed, educa¬ 
tion, and controlled amusements. Everything is de¬ 
vised for the special care of the tuberculous patient, 
and the entire routine is arranged for his benefit. 
At first glance this form of treatment would seem 
to be ideal. However, it is not the equipment, but 
the use that is made of it, that produces results. 

Nearly all of the sanitariums which treat tuber¬ 
culosis exclusively are operated strictly along medical 
lines. All those which are maintained by the gov¬ 
ernment and by charitable agencies for the use of 
poor people are so conducted. Consequently, while 
they have the equipment, the best use of it is not 
made. The patients are overfed, given drugs, which 
they would be better off without, and are instilled 
with the fear of germs and exercise. If it were 
possible to get the right treatment at sanitariums 
this plan of treatment would be ideal; but there are 
few such places in the country. It is for this rea¬ 
son that I place the sanitarium last instead of first. 
Further objections to the sanitarium plan include the 
expenses and the necessity for leaving home. The 
free or moderately priced sanitariums are so over¬ 
crowded that there is little chance of getting into 
one when it is necessary. Leaving home may not 
be so objectionable in some cases, and even has its 
249 


TUBERCULOSIS 


advantages; but there is the trip to be made, the 
extra expense, the anxiety about those at home, and 
other such drawbacks to be considered. 

The plan of going to a health resort (not a sani¬ 
tarium) has, perhaps, more advantages than disad¬ 
vantages. The expense may be as much or greater, 
but you usually can get the treatment that you want 
and need, by the simple expedient of treating your¬ 
self. Usually you can find a medical doctor who will 
be willing to work with you if desired, or there may 
be naturopaths in the health resort you choose. The 
two chief objections to the health-resort plan are 
the necessity for leaving home and of taking some¬ 
one along to do the nursing during the bed-rest 
period. To go to a nursing home at a health resort 
is little if any better than going to a sanitarium; you 
must be free to get the food that you need. If pos¬ 
sible to overcome these disadvantages the health- 
resort plan will be very helpful. You will have a 
favorable climate, plenty of fresh air, sun baths or 
other treatments, good milk, and, above all, people 
will not look upon you as a danger to society. Your 
affliction will be taken as a matter of course, and the 
natives and other patients will work with you instead 
of against you. 

However, if reasonably favorable conditions may 
be obtained at home it usually will be found best to 
stay right there. First of all, the expense will be less 
—or some of the money “saved” may be expended 
on home equipment. If you are not too sick you 
may be able to secure some light work which you 
250 


EQUIPMENT FOR TREATING TUBERCULOSIS 

can do at home even while resting. This will keep 
your mind occupied and help pay expenses. To the 
great majority of tuberculous patients the matter 
of expense is of great importance. Only a compara¬ 
tively few of such cases are in a position to disre¬ 
gard this important item. To those who must con¬ 
sider expense it is of primary importance that this 
matter be settled as soon as possible, because there 
are few things which interfere more with progress 
than worry about money matters. Decide what you 
wish to do, borrow some money if necessary, and 
then forget about money matters in the calm convic¬ 
tion that you will be able to make up for your losses 
wdthout trouble, because you are going to get well 
and be better in health than before. Health is more 
important than wealth, and no one realizes it any 
more than one who is flat on his back or “weak on 
his pins” with tuberculosis. 

By staying at home you will not have to become 
acclimated either during treatment or after the cure; 
you will be among familiar surroundings, with no 
danger of homesickness; and you will have those 
who care most for you to look after you. By mak¬ 
ing a few special arrangements for fresh air and 
sunlight you will be in a position to take the neces¬ 
sary treatment in peace. The advantages and dis¬ 
advantages of each plan must be considered in rela¬ 
tion to the individual case; but I believe it is usually 
preferable to make an effort to remain at home 
rather than to make an equal effort to go away. For 
this reason I am giving a number of suggestions in 
251 


TUBERCULOSIS 


this chapter whereby home conditions may be made 
to meet the patient’s requirements. 

The first necessity will be to arrange for fresh 
air. If you already have a sleeping porch you are 
fortunate. Simply make that your living quarters, 
and you will get all the fresh air necessary. If you 
have no such 
porch but can 
build one, you 
will be equally 
fortunate. Such 
a porch should 
have windows or 
other openings on 
three sides. These 
should extend 
from close under 
the roof to within 

two feet of the m . 

T ^ , An easily constructed sleeping porch 

floor. In ract, the w hich is suitable for country locations 
more open space but can onl y be used in fair weather. 

the better. Of course, there should be screens to 
protect from insects, and glass casements or canvas 
awnings to protect from the rain, snow or high 
winds. The glass casements (hinged windows that 
open like doors) are the most convenient, but they 
are expensive, and there is a tendency to keep them 
closed too much. Because they give one full bene¬ 
fit of the window opening they are preferable if 
used properly. But any window is satisfactory if 
used properly. 



252 









































EQUIPMENT FOR TREATING TUBERCULOSIS 

The canvas awnings are generally the best except 
in very cold climates. The roof should be solid and 
weather-proof; but if it can be arranged to be lifted 
when desired it will make sun baths possible on the 

porch. Linoleum 






i SMan 

ffTT 


iM «| 



i muni 

111 

v 

fp5= 

IP 

T 1 

D 


makes an excellent 
covering for the 

floor of the porch. 
The bed should be 
of iron, and there 

should be weather¬ 
proof coverings to 
be used in case of 
emergency. These 
are the necessities. 

The luxuries in¬ 
clude special light¬ 
ing and heating 
arrangements, addi¬ 
tional furniture, 
radio, toilet facili- 

An excellent torm ot living and ^ es > etc. As a rule 
sleeping porch, though of rather it is better to keep 

complicated construction. The sides furniture verv 

have blinds like shutters so that even # ^ 

when the porch windows and roof simple, and the 

are closed the ventilation is good. porch should be un¬ 
heated most of the time. If the patient is not con¬ 
fined to the bed all day no heat will be required. 
However, an electric heater often comes in very 
handy. A gas or oil heater should not be used, as 
they extract large amounts of oxygen from the air. 

253 





















































TUBERCULOSIS 


If unable to arrange for a porch of any kind a 
well-ventilated room should be selected. Windows 
should be on at least two sides of the room, and the 
more the better. They should be open to some ex¬ 
tent constantly, and to the fullest extent as many 
hours daily as possible. If the room is not any too 
well ventilated by windows it would be well to em- 



An indoor tent giving many of the advantages of the out ofi 
doors for bed patients. Especially valuable in the city where 
sleeping porches are rare and privacy is necessary. The win¬ 
dow may be closed and the tent lifted when the patient is 
eating, being bathed, etc., so that the room is not chilled. 

ploy a window tent while sleeping at night. There 
are a number of these on the market at moderate 
prices. They usually are well equipped with means 
for protection from bad weather; but it is advisable 
not to make too free use of these, or the tent will 
254 





















































EQUIPMENT FOR TREATING TUBERCULOSIS 

be of little value. When fully opened they allow 
a supply of air almost as good as that obtained 
when sleeping out of doors. The tent can be used 
during the day when desired. 

Various inside tent arrangements, also, can be 
devised. The bed must be placed close to the win¬ 
dow and the tent built over the head of it. The win¬ 
dow is then kept open both top and bottom. This 
arrangement does not give the supply of air that 



Another easily constructed, light, yet weather-proof tent for 
outdoor living. Of value mostly in good weather as when 
closed there is not sufficient ventilation. 


the outside tent gives, but it gives greater privacy, 
and in some cases may be more desirable. The chief 
advantage of the window tents and inside tents is 
that they permit the room to be kept warm in cold 
weather. This is a considerable advantage when 
space is limited or when facilities for quick heating 
are not available. 

In a climate where the weather is warm the year 
255 
















TUBERCULOSIS 


round the outside individual cottage or shack, which 
consists of little more than a floor and a roof, is 
very good. The same may be used in colder cli¬ 
mates by enclosing part of the building for dressing 
quarters. Tents are seldom so satisfactory because 
they are more likely to be damaged by wind and rain 
and are quite hot when the sun shines on them for 
some time. However, these drawbacks are less con¬ 
spicuous with strong tents double-roofed, with venti¬ 
lating space between the two roofs. A tent with 
side walls seldom gives as much fresh air as an ordi¬ 
nary bedroom. Whatever arrangements may be re¬ 
quired in certain circumstances, every effort should 
be made to approximate as closely as possible out¬ 
door living conditions. 

After having arranged for fresh air the next 
important thing is the sun bath. The chief diffi¬ 
culty here will be in securing the necessary privacy. 
Those who have a back yard screened from the pub¬ 
lic view will be fortunate. All they will have to do 
is to spread a blanket on the grass and lie down. In 
a less private yard a small space may be walled in 
with canvas. If the surrounding buildings are high 
the best place would be the roof or an upstairs un¬ 
roofed porch. Here, also, the side walls may be 
erected if necessary. Each one will know his own 
individual circumstances the best and can make what¬ 
ever arrangements are necessary for privacy, always 
remembering that the sunlight must not be ob¬ 
structed if any benefit is to be derived from nude 
exposures to it. 


256 


EQUIPMENT FOR TREATING TUBERCULOSIS 

Where outdoor sun baths are impossible, either 
because of lack of space or privacy, or because of 
cold weather, or because the patient is confined to 
bed, the baths can be taken indoors as has been 
described in the chapters on treatment—through the 
lowered top sash of a window. If one has a sleep¬ 
ing porch, the roof of which may be lifted, that 
will be found very convenient. If unable to arrange 
for the bath in any other way it may be taken while 



A good tent for outdoor living. It has windows in each 
end, which are covered with netting so that the tent is 
well ventilated even when the front flap is closed. Good 
for all kinds of weather. 

the body is covered with netting or some very loosely 
woven white cloth. Baths so taken will be better 
than no baths, though considerably inferior to the 
nude baths. In any case do not allow the remarks 
or opinions of the neighbors to deter you from 
getting your sun bath. Under present conditions 
of prudery and affected modesty it may be necessary 
to make some concessions to convention, but let it be 
as little as possible. 


257 




















TUBERCULOSIS 


Fortunately, within the past few recent years 
there have been developed special glasses and glass 
substitutes that permit passage of the invisible ultra¬ 
violet rays of sunlight, which ordinary glass reflects 
and absorbs. A new glass is made by at least two 
companies, and at least two glass substitutes are 
made. The new glass is crystal clear, hence as 
transparent as ordinary (sheet and plate) glass, 
though the manufacturers of at least one of the new 
glasses makes, also, a translucent (partially trans¬ 
parent) glass and a translucent glass in which is 
imbedded a wire screen—for use where strong, wire 
glass is required. The glass substitutes consist of 
light wire mesh work or screens (for strength) cov¬ 
ered with patented compositions. These resist the 
weather remarkably well, but naturally are not as 
durable as are the new glasses (and ordinary glass). 

By experimentation it has been found that when 
fowls are exposed to sunlight through the new 
glasses growth and all other processes of the body 
are increased as perfectly as when the bodies are 
exposed directly to ordinary sunlight; also, that 
these processes are greatly promoted when the bod¬ 
ies are indirectly radiated—that is, when the sun¬ 
light does not reach them directly, but reaches their 
quarters through the new glasses. This proves that 
the new glasses permit passage of all the vital 
health-building and health-protecting rays present in 
sunlight. Some hospitals and sanitariums have had 
rooms and roofs fitted with such glasses, and others 
are fitting rooms, roofs and porches with them. 

258 



EQUIPMENT FOR TREATING TUBERCULOSIS 

Experiments made with the glass substitutes at 
the same time experiments were being made with 
the new glass proved that, while the substitutes 
seemed to be less satisfactory for radiation than the 
new glasses, they were far superior to ordinary 
glass. Fowls exposed to the light coming through 


Showing how a natural sun bath can be taken indoors if the 
proper glass is used in the windows. Ordinary glass such as 
now used for windows does not permit the ultra-violet rays to 
pass but a special glass is now manufactured that will. 

the glass substitutes made far better growth and 
resisted rickets far better than control fowls exposed 
even to bright sunlight coming through ordinary 
glass—proving that most of the vital rays of sun¬ 
light passes through the substitutes, though not all 
as in case of the new glasses. The substitutes for 
glass are designed chiefly for fowl raisers, raisers 
















TUBERCULOSIS 


of vegetables and flowers under glass, and in animal 
husbandry. But there is no reason why they cannot 
be used satisfactorily in many homes. They are 
cheaper than ordinary glass, while the new glasses 
are much more expensive than ordinary glass, in fact, 
are prohibitive in cost to many people. 

The windows of even one room of a house easily 
could be fitted with either the new glass or glass 
substitutes, for the treatment of tuberculosis—or 
rickets or any other deficiency disease. A rear room, 
or a rear porch, or even a lean-to or improvised 
hut in the back yard could be covered or surrounded 
wholely or partially with either a new glass or a 
glass substitute. Living rooms could be provided 
with new glass in their windows, as a health-protec¬ 
tive measure. Many uses and methods of use will be 
presented to the reader, I am sure. The glass sub¬ 
stitutes can be used where privacy is desired. 

Doubtless the expense of production of the new 
glasses will be lowered in time, with quantity pro¬ 
duction. This will put them within reach of many 
people who now cannot secure them and who must 
use the glass substitutes if any change from ordinary 
glass is to be made. But without doubt these inven¬ 
tions constitute a great step forward in the preven¬ 
tion and treatment of various disorders due to, or 
made possible or intensified by, deficiency of the vital 
sunlight rays, perhaps especially including tubercu¬ 
losis and rickets. 

If artificial sunlight must be used it will be well 
for the patient to secure a lamp for his own 
260 


use, 


EQUIPMENT FOR TREATING TUBERCULOSIS 

that he may have it when needed. The ultimate 
expense will be less, also. The lamp will probably 
be required for a considerable time, and the rental 
charge of one would soon equal its purchase price. 
Many times it is possible to secure a second-hand 
lamp at a considerable reduction. As long as the 
burner is not too old it will be satisfactory. Or one 
may be able to secure a second-hand lamp and equip 
it with a new burner at less than the cost of an entire 
new lamp. There are two varieties, the mercury- 



An excellent style of sleeping bag, which can be placed 
directly on the ground even if it is snow covered as the 
bag is moisture proof. Very good for those who have no 
sleeping porch. 

quartz and the carbon-arc. The former is more 
convenient to use, but the rays of the latter are con¬ 
sidered to approximate more closely the natural sun¬ 
light. In cases where there is fever the former may 
be slightly better, as it gives less heat. However, 
recent improvements in the carbon-arc lamps have 
made them safer and more convenient to use. It 
would be advisable for the patient to secure infor¬ 
mation on both varieties before deciding which best 
261 








TUBERCULOSIS 



meets his particular needs. For local radiations the 
water-cooled mercury-quartz lamp usually is the 
best; but since these lamps are more difficult to use, 
and even more expensive than those for general ra¬ 
diations, it is best to secure from a doctor what 
treatments are necessary. 

For patients who are up part or much of the 


Special reclining chair for the use of tuberculous patients. 
Considerable rest is required at the start of treatment and 
such a chair will be much appreciated. 

time, a reclining chair is a great convenience. This, 
of course, is not a necessity, as the bed or any easy 
chair may be used. If economy is an important fac¬ 
tor the special chair may be omitted. If one is se¬ 
cured it should be of substantial construction yet not 
too heavy to be easily moved about. An ordinary 
folding beach chair is seldom very satisfactory. The 
best chair to get is one designed for the purpose, 
known as a recliner. There are several on the mar- 







An “Eskimo” suit, made specially for those who are living or 
sleeping out of doors. Such a heavy woolen garment is not 
so good for sleeping but is excellent when resting outside in 
cold weather. 

263 









TUBERCULOSIS 


ket, any of which should be satisfactory. The chief 
difference is in luxury of appointments and excel¬ 
lence of materials. 

Clothing is an important factor for patients tak¬ 
ing treatment in cold climates. As I have stated 
before, the amount should be kept at a minimum; 
but when living outdoors with the temperature at 
or near zero, some considerable protection is neces¬ 
sary. Fur robes or coats are to be preferred, but 
heavy woolens will answer. An auto robe or 
steamer blankets may be used for the reclining chair. 
A good substitute for fur robes or heavy blan¬ 
kets may be made by placing five or six layers 
of newspaper or heavy tissue paper between 
two pairs of blankets and knotting the whole 
together with yarn after the manner of quilt¬ 
ing. Woolen caps which pull down over the 
ears should be used to protect the head. When 
sleeping out in severe weather a sleeping bag will be 
a great help. If one of these cannot be obtained, 
down quilts and woolen blankets may be employed, 
as these are light, but warm. Stone jugs filled with 
hot water are good to place at the feet if the cir¬ 
culation is poor. These are familiarly known as 
“pigs.” If necessary a hot-water bottle may be 
placed on the back, also. Electric heating pads may 
be used. It is advisable to get along with as little 
of this artificial heat as possible; but the body should 
not be required to expend its precious energy in com¬ 
bating cold. Bed socks may be necessary for the 
feet in very cold weather. When resting outdoors 
264 


EQUIPMENT FOR TREATING TUBERCULOSIS 


during the day one may wear “foot warmers” made 
of sheepskin, which pull on over the shoes. 

The sanitary equipment required includes the 
fountain syringe, a bed pan for bed cases, and spu¬ 
tum cups. The latter are made in various designs 
and of various materials. There are two general 
types—those made of paper which can be completely 
burned, and those having a metal or leather case in 


which paper 
cups are in¬ 
serted. These 
cups are neces¬ 
sary chiefly for 
those patients 
who are in a 
position to walk 
about and be up 



A handy sanitary sputum cup. The cup is f n f f u „ 

on the right and the container on the left. 

The cups are made of pasteboard and can time. For cases 
be removed frequently and burned. which are con¬ 
fined to bed and where economy is a factor, paper 
napkins or ordinary toilet paper may be used, each 
piece as used being deposited in a paper bag. The 
bag should be removed after a very few hours and 
burned, and replaced with another. It is not advis¬ 
able to make much use of handkerchiefs, as they are 
difficult to cleanse. Also, as they must be laundered 
so frequently and vigorously they soon wear out. 

It may seem rather strange to include books in 
equipment for the treatment of tuberculosis, but I 
believe they are important. I sincerely hope that 
265 









TUBERCULOSIS 


this book will be considered by the patient a very 
important and helpful part of his equipment. A 
monthly health magazine, also, is a considerable 
help, as it is a constant reminder of the necessity for 
right living and a regular inspiration that helps to 
keep up the hope and courage. Physical Culture 
Magazine, other health magazines, and periodicals 
devoted to practical psychology and spiritual heal¬ 
ing, all are good. The mind needs food as does the 
body. Reading of the proper kind will help much 
in maintaining the proper mental attitude. Of 
course, some lighter reading, also, may be permitted 
for amusement. This should not be especially excit¬ 
ing. Short stories usually are to be preferred to 
fiction books, as one will be less inclined to read to 
excess. The patient will be surprised to find how 
little spare time he has, even when resting in bed. 
By the time he has done all the necessary things, 
observed the rest periods and done his inspirational 
and instructive reading, there will be little time left. 
This is as well, for reading merely for the sake 
of reading uses up considerable energy through use 
of the eyes and the appeal to the emotions, and gives 
little or nothing in return. 

A very important part of the “equipment” of the 
patient will be the doctor and the nurse. It is not 
always necessary to have a doctor if the patient is 
well versed and to some extent experienced in the 
application of natural methods of treatment. But 
as a rule it is desirable and beneficial to have some 
guidance to relieve oneself of the full responsibility. 

266 


EQUIPMENT FOR TREATING TUBERCULOSIS 


The doctor will also keep a check on the progress 
made, by means of special examinations which the 
patient could hardly make himself. Ordinarily I do 
not recommend specialists, as they usually know 
only one thing. But in the case of tuberculosis a 
specialist is valuable, for the reason that most of 
them have had the disease themselves, have been 
“through the mill,” and are more likely to under¬ 
stand the patient and to be open to new ideas in the 
treatment of the disease. There are all too few 
practitioners of natural methods, or medical men 
who believe in and use natural methods, hence most 
patients will have to depend upon the so-called 
“regular” doctors. Try to find one who is willing to 
work with you instead of merely issuing orders. 
Quite a few are becoming interested in diet now, and 
a really broad-minded medical man will be glad of 
the opportunity to try the methods of treatment we 
recommend. 

It is seldom that a trained nurse will be required. 
A relative of the right kind can look after the pa¬ 
tient’s needs during the period of bed rest, which 
should not be long when the proper methods are 
used. If necessary, a practical nurse may be secured. 
The trained nurse usually is medically trained and is 
too much inclined to look with disapproval on the 
use of natural methods of treatment. Whatever at¬ 
tendant is secured, however, it is important that he 
or she, as well as the patient, read this book so that 
there can be more complete cooperation. It is 
267 


TUBERCULOSIS 


especially important that such an attendant be pa¬ 
tient, cheerful, optimistic and healthy. 

All the necessary equipment for the patient’s 
course of treatment should be planned and secured 
as soon as possible in order that he may have his 
mind free to devote all his attention to getting well. 
Problems of all kinds should be kept from the pa¬ 
tient as far as possible, as a calm, peaceful, unhur¬ 
ried and unharried opportunity to get well will be 
of the greatest assistance. 


268 


CHAPTER XVI 

Medical Treatment of Tuberculosis 



HE present medical treatment of tuberculosis 


includes many good points, such as rest, fresh 
air, ultra-violet radiations, and more fruits, vegeta¬ 
bles and milk in the diet than formerly. But it also 
contains some bad points that it would be well to 
omit. I have included this chapter in order to ac¬ 
quaint the patient with some of these, that they 
may be avoided. 

Some years ago all kinds of drugs were tried in 
an effort to “cure” tuberculosis. One by one they 
were discarded, but the last to give up the ghost 
was creosote. This is still used in some cases, 
though it is admitted that it is not a cure. The 
doctors recognize the fact that they have no drug 
or other agent which has a selective action on the 
tubercle bacillus and will kill it without injuring 
the body. Even if they possessed such a medicine 
the causes of the trouble would still be present, and 
more bacilli would come or some other disease would 
develop. 

The present trend in the medical treatment of 
all diseases is toward the use of serums and vac¬ 
cines rather than drugs. Many of these have been 
tried for tuberculosis. The only one which has any 


269 


TUBERCULOSIS 


reputation left at present is tuberculin, and that is 
good (?) only in “selected cases.” The question 
might well be asked, why, if it is a real help, does it 
not assist all cases? I believe the truth of the matter 
will be found to be that those cases which have 
the vitality to react with an extraordinary effort 
to throw off the tuberculin may at the same time 
throw off some of the toxins causing the disease, 
and thereby secure improvement-—but only at the 
expense of a considerable loss of energy. 

The widest use of drugs in tuberculosis is for the 
suppression of symptoms. To be sure, the best doc¬ 
tors use them very sparingly; but there are plenty 
who find it much easier to give a drug than to do a 
little work on the patient, such as applying packs 
and compresses. There are many drugs that are 
used. Aspirin often is given for the relief of pain 
in pleurisy or other conditions. This causes a fast 
heart, so digitalis is given to slow it down. Atropin 
is employed to check the night sweats. These should 
be let alone, as the sweats assist in eliminating tox¬ 
ins. For cough, codein, chloroform and the bro¬ 
mides frequently are given. For diarrhea various 
combinations of bismuth are frequently employed, 
and in severe cases morphine or opium may be ad¬ 
ministered. Ergot is used when there is a large 
hemorrhage. Various “tonics” are employed much 
too frequently, especially for stimulating the appe¬ 
tite. When the appetite is destroyed by overfeed¬ 
ing, a tonic is given to stimulate it, with the result 
270 


MEDICAL TREATMENT OF TUBERCULOSIS 


that all sorts of digestive disturbances occur. The 
best way to avoid the necessity of refusing such med¬ 
ication is to give strict attention to the diet and 
other measures I have suggested. 

In spite of all their failures to find a medicine or 
vaccine to overcome tuberculosis the doctors are still 
searching for a “cure.” They realize by now that 
only Nature heals, yet they still imagine that they 
may find some wonderful remedy that will make it 
unnecessary for the patient to pay his debt to Na¬ 
ture by strict adherence to right habits of living. 
They have seen that the use of natural methods is 
most effective in tuberculosis, but they do not give 
these methods any credit for being effective in other 
diseases. They seem to have the idea that they are 
depending on them merely because thev have noth¬ 
ing better. It would seem that anv thinking per¬ 
son could easily discern that if natural methods or 
right living are effective in such a serious condition 
as tuberculosis, when all else has failed, they must 
be the best, the right, and the only methods for elim¬ 
inating all diseases. I hope I have succeeded in 
convincing my readers of this fact, because upon 
this conviction depends their future health and hap¬ 
piness. 

In regard to surgery, I have discussed this to 
some extent in other parts of this book. It has 
been totally discredited in lung cases, but is still 
used to a considerable extent in bone, gland and, 
sometimes, skin cases. However, its use is decreas- 
271 


TUBERCULOSIS 


ing since the introduction of the ultra-violet lamps, 
and it is to be hoped that it will soon be discontinued 
entirely. Cutting out effects can never remove 
causes; the disease will break out in other parts, or 
some other abnormal condition will develop. When 
the body needs extra elimination it must have it if 
life is to continue. 

There is another special treatment that is some¬ 
times used in severe cases, known as artificial pneu¬ 
mothorax. This consists of collapsing the lung by 
the introduction of gas, the idea being to give the 
lung absolute rest. Natural pneumothorax some¬ 
times results from an ulcer within the lung eating 
through an air passage and one layer of the pleura, 
allowing air to enter between the pleural layers, 
where it collapses the lung by its pressure. Symp¬ 
toms are pain, shortness of breath and collapse. In 
most cases recovery results by healing of the ulcera¬ 
tion and gradual absorption of the air. Such a na¬ 
tural collapse of the lung occurs only in severe and 
advanced cases, and it is only in such cases that arti¬ 
ficial pneumothorax is employed. 

This is well, for it is truly a last resort and can 
be used only under certain circumstances. For in¬ 
stance, the other lung must be fairly sound, as all the 
work of breathing and respiratory elimination will 
be placed upon it. If this lung is not in good condi¬ 
tion the extra work may make it much worse, and 
the patient’s condition as a whole will be more 
serious. If the patient has had pleurisy, with the 
development of adhesions, these may prevent the 
272 


MEDICAL TREATMENT OF TUBERCULOSIS 

collapse of the lung either partly or entirely. The 
effort to collapse such a lung and the shock of the 
treatment may make such a patient worse. Hence, 
it will be seen that this treatment is quite dangerous 
and should usually be avoided. I am ready to ad¬ 
mit, however, that in some cases it may be helpful, 
especially if the patient is one who will not take 
proper care of himself. In this case, however, the 
relief is only temporary, because the wrong habits of 
living soon produce further trouble. 

The method of bringing about artificial pneumo¬ 
thorax is to plunge a hollow needle into the chest 
far enough to penetrate the outside layer of the 
pleura, after which nitrogen gas is injected gradually 
through the needle. From 200 to 800 cubic centi¬ 
meters of gas are employed. Ordinary air may be 
used, but the nitrogen gas usually is preferred. As 
the air is gradually absorbed the injection needs to 
be repeated, at first every four to six days, but later 
only every four to six weeks. The lung may be col¬ 
lapsed for as long as a year. Gradual withdrawal 
is advisable. 

But after all is said and done, the chief reliance 
in overcoming tuberculosis must be placed upon the 
ordinary forces of Nature—fresh air, sunlight, 
proper food, water, rest, and exercise in its place. 
Nothing can excel these in efficiency. These make 
up our natural environment; and since it is through 
misuse or disuse of our environment that disease is 
brought about, the most effective way to overcome 
disease is to make proper use of the environment. 

273 


TUBERCULOSIS 


No other method will suffice. If the patient will 
have absolute confidence in the healing power of 
Nature and will patiently and confidently adhere to 
right habits of living he will not be disappointed. 
Symptoms may arise from time to time, but one 
should not allow his confidence to be shaken. Re¬ 
member what I have said about symptoms being 
curative efforts, and realize that a little discomfort 
may be necessary during the process of getting well. 
It is the price we pay for our former indiscretions. 

No one desires to have tuberculosis. But if the 
proper mental attitude is maintained the disease 
may be turned into a blessing, for in the process of 
getting well the patient will learn how to live, how 
to control his thoughts and actions, and will reach 
a true appreciation of the beauty and value of living 
close to Nature. Never again will he be inclined 
to stray so far from the path of healthful living, 
and the knowledge and experience he has gained 
will be of value to him all through what should be 
a long and useful life. 

[the end] 


274 














■ 














































■ 




1 .. 

. 



































































